Individual
LORI HUNDLEY HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110002208
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010397782
—
VA
05
—
010397821
—
VA
05
—
010397855
—
VA
01
—
1068473
NAACP CERTIFICATION
—
Enumeration date
02/02/2007
Last updated
03/19/2013
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