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Individual

DR. LEE W HODGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
797 TEAL DRIVE, CONWAY, AR 72034-8002
(501) 329-2774
(501) 327-0907
Mailing address
PO BOX 1600, CONWAY, AR 72033-1600
(501) 329-2774

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1439
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18895000040
QUAL CHOICE OF ARKANSAS
AR
01
2459961
CIGNA
AR
01
44-20060
UNITED HEALTH CARE
AR
01
5T646
BLUE CROSS BLUE SHIELD
AR
01
710847827
PIN
AR
01
721190
AETNA
AR
01
S02725
NOVA SYSTEMS
AR
Enumeration date
01/20/2006
Last updated
06/24/2011
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