Provider Demographics
NPI:1194722686
Name:HODGES, PETER T (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:T
Last Name:HODGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9743 HASTINGS ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66227-4903
Mailing Address - Country:US
Mailing Address - Phone:785-532-8990
Mailing Address - Fax:
Practice Address - Street 1:9743 HASTINGS ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66227-4903
Practice Address - Country:US
Practice Address - Phone:785-532-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27680207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
102204OtherBCBS OF KS
200045522OtherRAILROAD MEDICARE
KS04-27680OtherSTATE LICENSE
KS100423450AMedicaid