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Organization

JEFFREY R HODGSON MD CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY ROSS HODGSON MD (PRESIDENT)
(312) 305-9378
Entity
Organization

Contact information

Practice address
20100 QUARTZ MOUNTAIN RD, N, FIDDLETOWN, CA 95629
(209) 206-1177
(209) 206-1177
Mailing address
PO BOX 2131, APTOS, CA 95001-2131
(312) 305-9378

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A100211
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629278494
CA
Enumeration date
05/16/2017
Last updated
09/05/2024
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