Provider Demographics
NPI:1831535863
Name:HODGES, MEGAN GENTRY (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:GENTRY
Last Name:HODGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:GENTRY
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE CIRCLE #1600
Mailing Address - Street 2:CENTRACARE CLINIC HEALTH PLAZA RADIOLOGY/ONCOLOGY
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-229-4901
Mailing Address - Fax:320-229-4920
Practice Address - Street 1:1900 CENTRACARE CIRCLE #1600
Practice Address - Street 2:CENTRACARE CLINIC HEALTH PLAZA RADIOLOGY/ONCOLOGY
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-229-4901
Practice Address - Fax:320-229-4920
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN621842085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program