Individual
SUSAN M. HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
602 KNOX ST, BARBOURVILLE, KY 40906-1304
(606) 546-6027
(606) 546-2084
Mailing address
602 KNOX ST, BARBOURVILLE, KY 40906-1304
(606) 546-6027
(606) 546-2084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA896
KY
363AM0700X
Medical Physician Assistant
PA896
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100120360
—
KY
01
—
P01439763
RR MEDICARE
KY
Enumeration date
09/13/2006
Last updated
02/05/2016
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