Provider Demographics
NPI:1982601696
Name:HODGES, JOSEPH J (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:HODGES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:JAMES
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 2722
Mailing Address - Street 2:
Mailing Address - City:HARBOR
Mailing Address - State:OR
Mailing Address - Zip Code:97415-0325
Mailing Address - Country:US
Mailing Address - Phone:541-469-2276
Mailing Address - Fax:541-469-0489
Practice Address - Street 1:411 MILL BEACH RD.
Practice Address - Street 2:SUITE A
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415
Practice Address - Country:US
Practice Address - Phone:541-469-2722
Practice Address - Fax:541-469-0489
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2788111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR108906Medicare ID - Type Unspecified