# GENE K. HODGES M.D.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 1316055320
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366984437
- **Legal business name:** 1316055320
- **Authorized official:** PATRICIA C WHITE (BOOKKEEPER)
- **Authorized official phone:** (208) 522-3301

## Contact information

- **Practice address:** 2065 E 17TH ST, SUITE A, IDAHO FALLS, ID 83404-8042
- **Practice address phone:** (208) 522-3301
- **Practice address fax:** (208) 522-3414
- **Mailing address:** 2065 E 17TH ST, SUITE A, IDAHO FALLS, ID 83404-8042
- **Mailing address phone:** (208) 522-3301
- **Mailing address fax:** (208) 522-3414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | M4937 | ID | Yes |

## Other

- **Enumeration date:** 11/07/2016
- **Last updated:** 11/07/2016