# THOMAS L. HEDGE, M.D. A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811137557
- **Authorized official:** MRS. SHIRLEY VIOLA JOHNSON (ADMINISTRATOR)
- **Authorized official phone:** (661) 618-1771

## Contact information

- **Practice address:** 18300 ROSCOE BLVD 4IFL TOWER, NORTHRIDGE, CA 91325-4167
- **Practice address phone:** (818) 885-5342
- **Practice address fax:** (818) 727-1451
- **Mailing address:** PO BOX 8300, NORTHRIDGE, CA 91327-8300
- **Mailing address phone:** (661) 618-1771
- **Mailing address fax:** (661) 287-9471

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | NULL | Yes |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/20/2009
- **Last updated:** 02/20/2009