Individual
LORALIE ELLINGTON HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3505
(316) 759-6660
Mailing address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3505
(316) 759-6300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1739
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20410560A
—
KS
01
—
651140
BCBS
KS
Enumeration date
09/22/2006
Last updated
11/19/2025
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