Individual
JOHN BART HODGENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5325 26TH ST W, BRADENTON, FL 34207-3012
(941) 752-7173
(941) 567-6277
Mailing address
700 8TH AVE W STE 101, PALMETTO, FL 34221-4737
(941) 776-4000
(941) 845-4963
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY8338
FL
103TC2200X
Clinical Child & Adolescent Psychologist
475
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000075068
—
LA
05
—
003995100
—
FL
01
—
051075068
BLUECROSS AND BLUESHIELD
AL
Enumeration date
04/24/2007
Last updated
11/09/2018
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