Individual
MR. ALEXANDER STEPHEN HODGENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8901 ROCKVILLE PIKE, BETHESDA, MD 20889-2111
(315) 256-3951
Mailing address
143 NORTH WAY, CAMILLUS, NY 13031-1253
(315) 256-3951
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207R00000X
Internal Medicine Physician
Primary
0102206873
VA
363A00000X
Physician Assistant
PA4789
MA
363AM0700X
Medical Physician Assistant
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S400115016
—
MA
Enumeration date
09/05/2011
Last updated
08/07/2023
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