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Individual

DR. KEITH R HODGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4801 W 135TH ST, LEAWOOD, KS 66224-8901
(913) 663-3838
(913) 663-4434
Mailing address
4801 W 135TH ST, LEAWOOD, KS 66224-8901
(913) 663-3838
(913) 663-4434

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04-30074
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G39C506
MEDICARE
KS
01
G39C506A
MEDICARE
MO
Enumeration date
05/17/2006
Last updated
08/04/2010
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