Individual
ROBERT W HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6411 VETERANS MEMORIAL PARKWAY, CREESTWOOD, KY 40014-8611
(502) 241-8611
(502) 241-4175
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18819
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00533118
KYMEDICARE-NCMA
KY
01
—
099096
SIHO/NCMA
—
01
—
50021271
PASSPORT/NCMA MIDD
—
01
—
50021974
PASSPORT/NCMAPEWEE
—
01
—
64188196
MEDICAID/NCMA
KY
05
—
64188196
—
KY
01
—
P00736602
RMEDICARE/NCMA
KY
Enumeration date
11/07/2006
Last updated
04/23/2024
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