Individual
JONATHAN WADE HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1061 HARMON AVE STE 1D03, FORT STEWART, GA 31314-5641
(912) 435-6965
Mailing address
1061 HARMON AVE STE 1D03, FORT STEWART, GA 31314-5641
(706) 496-6423
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN184052
GA
Other
Enumeration date
12/21/2012
Last updated
04/29/2015
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