Individual
BENJAMIN HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-7888
Mailing address
PO BOX 249, FORT ATKINSON, WI 53538-0249
(920) 563-4466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.006721
IL
363A00000X
Physician Assistant
Primary
5474-23
WI
363AM0700X
Medical Physician Assistant
085.006721
IL
363AS0400X
Surgical Physician Assistant
085.006721
IL
Other
Enumeration date
08/24/2018
Last updated
10/07/2022
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