Provider Demographics
NPI:1770554099
Name:HODESS, ARTHUR BART (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:BART
Last Name:HODESS
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 1:154 EXTON SQUARE MALL
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2440
Mailing Address - Country:US
Mailing Address - Phone:484-876-2160
Mailing Address - Fax:
Practice Address - Street 1:154 EXTON SQUARE MALL
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2440
Practice Address - Country:US
Practice Address - Phone:484-876-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017100E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0026182000OtherINDEPENDENCE BLUE CROSS
PA0006817090003Medicaid
PA024930FGMMedicare ID - Type Unspecified
PA0026182000OtherINDEPENDENCE BLUE CROSS