Individual
MADELEINE HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3495 IRON HORSE RD, LADSON, SC 29456-4319
(601) 513-6073
Mailing address
6540 NEWELL RD, MERIDIAN, MS 39305-2307
(601) 513-6073
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5071
SC
Other
Enumeration date
10/10/2023
Last updated
11/07/2023
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