Individual
DR. TIMOTHY C. HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
665 WINTER ST SE, SALEM, OR 97301-3934
(503) 814-8272
Mailing address
665 WINTER ST SE, SALEM, OR 97301-3934
(503) 814-8272
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
0428604
KS
2086S0129X
Vascular Surgery Physician
113383
MO
2086S0129X
Vascular Surgery Physician
Primary
MD201655
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100289250E
—
KS
05
—
208714832
—
MO
01
—
P00153164
R R MEDICARE
MO
Enumeration date
10/13/2006
Last updated
05/08/2023
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