Provider Demographics
NPI:1801079819
Name:HODGES VISION LLC
Entity type:Organization
Organization Name:HODGES VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:270-792-1251
Mailing Address - Street 1:PO BOX 1659
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42142-1659
Mailing Address - Country:US
Mailing Address - Phone:270-792-1251
Mailing Address - Fax:
Practice Address - Street 1:507 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1539
Practice Address - Country:US
Practice Address - Phone:270-792-1251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty