Individual
STANLEY M HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 MED TECH PKWY, JOHNSON CITY, TN 37604-2630
(423) 794-5520
(423) 282-0720
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5520
(423) 282-6940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35007
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609851351
—
VA
05
—
3861671
—
TN
05
—
3861679
—
TN
01
—
4124140
BCBS OF TENNESSEE
TN
01
—
4346248
BCBSTN
TN
01
—
4346327
BCBSTN
TN
05
—
6406054400
—
KY
01
—
P00384556
RAILROAD MEDICARE
TN
05
—
Q002682
—
TN
01
—
TN01Y9
BCBS OF TN
TN
Enumeration date
12/14/2005
Last updated
02/19/2025
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