Organization
GENE K. HODGES M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENE K HODGES M.D. (OWNER)
(208) 522-3301
Entity
Organization
Contact information
Practice address
2065 E 17TH ST, SUITE A, IDAHO FALLS, ID 83404-8042
(208) 522-3301
(208) 522-3414
Mailing address
2065 E 17TH ST, SUITE A, IDAHO FALLS, ID 83404-8042
(208) 522-3301
(208) 522-3414
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
M4937
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000316100
—
ID
01
—
1164755104
INDIVIDUAL NPI NUMBER
ID
01
—
1316055320
INDIVIDUAL NPI NUMBER
ID
05
—
808464700
—
ID
Enumeration date
03/15/2007
Last updated
11/07/2016
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