Provider Demographics
NPI:1942216049
Name:HODGSON, TIFFANY LORRAINE (DPM)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:LORRAINE
Last Name:HODGSON
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:PO BOX 1070
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02722-1070
Mailing Address - Country:US
Mailing Address - Phone:508-676-3292
Mailing Address - Fax:
Practice Address - Street 1:289 PLEASANT ST
Practice Address - Street 2:STE 401
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-676-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2218213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0703401Medicaid
MA7997286OtherCIGNA
MAAA23770OtherHARVARD PILGRIM HEALTH
MA000000029116OtherHEALTHNET PLAN
RI29369-7OtherRHODE ISLAND BS
RI412437OtherRHODE ISLAND BLUE CHIP
MAY71121OtherBLUE SHIELD OF MA
MA462334OtherTUFTS HEALTH PLAN
V02187Medicare UPIN
MA000000029116OtherHEALTHNET PLAN
MA7997286OtherCIGNA