Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 01042523A | IN |
NPI | 1003899436 |
---|---|
Provider Name | Dr. Michael J Hodkin |
First Address | Muncie, IN 47304-3988 |
Second Address | Muncie, IN 47304-3988 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 21/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100387770 | (05) | IN |