Organization
LEE W. HODGE D.C. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE W HODGE D.C. (CHIROPRACTOR)
(501) 329-2774
Entity
Organization
Contact information
Practice address
1214 HOGAN LN, STE 200, CONWAY, AR 72034-8002
(501) 329-2774
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
QCA
AR
01
—
44-20060
UNITED HEALTH CARE
AR
01
—
5T646
BLUE ADVANTAGE
AR
01
—
7211190
AETNA
AR
01
—
P00228479
MEDICARE (RAILROAD)
GA
01
—
S02725
NOVA SYSTEMS
AR
Enumeration date
10/05/2006
Last updated
08/22/2020
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