Provider Demographics
NPI:1902807522
Name:HODGSON, DAVID K (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:HODGSON
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 1:302 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66968-2029
Mailing Address - Country:US
Mailing Address - Phone:785-325-2240
Mailing Address - Fax:785-325-2277
Practice Address - Street 1:302 E 2ND ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:KS
Practice Address - Zip Code:66968-2029
Practice Address - Country:US
Practice Address - Phone:785-325-2240
Practice Address - Fax:785-325-2277
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-18394173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100169330AMedicaid
KS100589Medicare ID - Type Unspecified
KS100169330AMedicaid