Provider Demographics
NPI:1649153982
Name:HODGE, GRACYE MAE (PA)
Entity type:Individual
Prefix:
First Name:GRACYE
Middle Name:MAE
Last Name:HODGE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:GRACYE
Other - Middle Name:MAE
Other - Last Name:CURETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:CASH
Mailing Address - State:AR
Mailing Address - Zip Code:72421-0009
Mailing Address - Country:US
Mailing Address - Phone:870-919-7984
Mailing Address - Fax:
Practice Address - Street 1:225 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3111
Practice Address - Country:US
Practice Address - Phone:870-207-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant