Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35-06-2777 | OH |
N | 208600000X | Surgeon | 35-06-2777 | OH |
N | 208200000X | Surgeon | MD0578081 | PA |
N | 208600000X | Surgeon | MD0578081 | PA |
N | 208200000X | Surgeon | ME100609 | FL |
N | 208600000X | Surgeon | ME100609 | FL |
Y | 2086S0129X | Vascular Surgeon | ME100609 | FL |
NPI | 1003801333 |
---|---|
Provider Name | Kevin Marcell Hoddinott |
First Address | Ocala, FL 34478-3130 |
Second Address | Ocala, FL 34471-6505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 23/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
281126000 | (05) | FL |
29763 | BCBS (01) | FL |
G22817 | (02) |