Individual
JUVONDA S HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-1229
(601) 815-4570
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-1318
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
24700
AL
208600000X
Surgery Physician
Primary
32486
MS
208600000X
Surgery Physician
71993
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126030
—
MS
05
—
009994070
—
AL
05
—
009994110
—
AL
01
—
020053576
RAILROAD MEDICARE PTAN
GA
01
—
17-00211
UNITED HEALTH CARE
AL
05
—
264984500
—
FL
01
—
51510674
BLUE CROSS
AL
01
—
51510858
BLUE CROSS
AL
01
—
51537957
BCBS - 1720 CENTER ST
AL
Enumeration date
05/24/2006
Last updated
12/21/2023
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