Provider Demographics
NPI:1437159787
Name:HODGES, EUNICE V (DPM)
Entity Type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:V
Last Name:HODGES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11143 WINCHESTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2717
Mailing Address - Country:US
Mailing Address - Phone:504-822-1155
Mailing Address - Fax:504-822-1177
Practice Address - Street 1:11143 WINCHESTER PARK DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-2717
Practice Address - Country:US
Practice Address - Phone:504-822-1155
Practice Address - Fax:504-822-1177
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD322R213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1461962Medicaid
LAU99271Medicare UPIN
LA1461962Medicaid