Provider Demographics
NPI:1528034311
Name:HODNY, LEE J (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:J
Last Name:HODNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2214 CANTERBURY DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2375
Mailing Address - Country:US
Mailing Address - Phone:785-623-5806
Mailing Address - Fax:785-623-2343
Practice Address - Street 1:2214 CANTERBURY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2375
Practice Address - Country:US
Practice Address - Phone:785-623-5806
Practice Address - Fax:785-623-2343
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-25108207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100166790BMedicaid
KS051541Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #
KS100166790BMedicaid