Individual
JERRY F HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 N 4TH ST, DARDANELLE, AR 72834-3713
(479) 229-2827
(479) 229-5749
Mailing address
PO BOX 637, DARDANELLE, AR 72834-0637
(479) 229-2827
(479) 229-5749
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C5406
AR
207Q00000X
Family Medicine Physician
Primary
C5406
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106616001
—
AR
Enumeration date
07/06/2006
Last updated
08/28/2014
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