Provider Demographics
NPI:1619937273
Name:HODGES, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:HODGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N PATRICK STREET
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76446-1918
Mailing Address - Country:US
Mailing Address - Phone:254-445-4900
Mailing Address - Fax:254-445-4693
Practice Address - Street 1:303 N PATRICK STREET
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:TX
Practice Address - Zip Code:76446-1918
Practice Address - Country:US
Practice Address - Phone:254-445-4900
Practice Address - Fax:254-445-4693
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1316465-04Medicaid
TX86J241OtherBLUE SHIELD
TX110212230OtherRR/MEDICARE
TX1316465-04Medicaid
TXC16993Medicare UPIN