Provider Demographics
NPI:1881732998
Name:HODGES, GEORGE F (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:HODGES
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 1:35812 249TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-6851
Mailing Address - Country:US
Mailing Address - Phone:360-802-1312
Mailing Address - Fax:
Practice Address - Street 1:315 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4234
Practice Address - Country:US
Practice Address - Phone:253-403-1043
Practice Address - Fax:253-405-1357
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023316207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8146763Medicaid
WA8146763Medicaid
WAF53503Medicare UPIN
WA220011075Medicare PIN
WAG001050408Medicare PIN