Individual
THOMAS H HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
551 LONE PINE BLVD, THE DALLES, OR 97058-9403
(541) 296-7724
(541) 296-7605
Mailing address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 296-7724
(541) 296-7605
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD11240
OR
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
MD11240
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1059708
—
WA
05
—
261248
—
OR
Enumeration date
11/22/2005
Last updated
01/02/2014
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