Individual
DR. J . TIMOTHY HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11415 EXECUTIVE CENTER DRIVE, LITTLE ROCK, AR 72211-4489
(501) 224-5220
(501) 228-9828
Mailing address
11415 EXECUTIVE CENTER DRIVE, LITTLE ROCK, AR 72211-4489
(501) 224-5220
(501) 228-9828
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-5203
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-20103
UNITED HEALTHCARE
AR
01
—
080008954
RAILROAD MEDICARE
—
05
—
105361001
—
AR
01
—
11164000000
QUALCHOICE
AR
Enumeration date
06/21/2005
Last updated
11/21/2013
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