Individual
DOUGLAS JOHN HODGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2552 E 3RD ST, BLOOMINGTON, IN 47401-7882
(812) 332-3432
Mailing address
5830 E 2ND ST # 96438, CASPER, WY 82609-4308
(307) 277-5282
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003064A
IN
152W00000X
Optometrist
268T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116258600
—
WY
Enumeration date
11/13/2006
Last updated
04/21/2021
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