Provider Demographics
NPI:1396920849
Name:SHERRY HODGE AU.D., LLC
Entity type:Organization
Organization Name:SHERRY HODGE AU.D., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:765-608-3277
Mailing Address - Street 1:1827 N MADISON AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-2166
Mailing Address - Country:US
Mailing Address - Phone:765-608-3277
Mailing Address - Fax:765-608-3278
Practice Address - Street 1:1827 N MADISON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-2166
Practice Address - Country:US
Practice Address - Phone:765-608-3277
Practice Address - Fax:765-608-3278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001704A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty