Doctor Name: | DR. LARRY HODSON |
NPI Number: | 1003826306 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | PO 1128 |
Business Practice Address: | 2201 Jenks Ave Panama City, FL - 324054531 |
Business Phone Number: | 8507690325 |
Business Fax Number: | 8507694476 |
Mailing Address: | 2201 Jenks Ave, PANAMA CITY |
State: | FL |
Postal Code: | 324054531 |
Phone Number: | 8507690325 |
Fax Number: | 8507694476 |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 02/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | PO 1128 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |