Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 47914 | WI |
N | 207XS0106X | Orthopaedic Hand Surgeon | 47914 | WI |
NPI | 1285685016 |
---|---|
Provider Name | Dr. Mark E Hodgson |
First Address | Milwaukee, WI 53226-1444 |
Second Address | Milwaukee, WI 53226-1444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 18/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
039906262U | HUMANA (01) | |
34648700 | (05) | WI |
I42558 | (02) |