Hodgson, Kim J

Hodgson, Kim J is an individual health care provider with primary practice located at 340 W Miller St , Springfield IL 62702-4928. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Hodgson, Kim J can be contacted via phone (217) 545-5555.

Contact Information

Primary practice address
340 W Miller St Springfield IL 62702-4928
Phone: (217) 545-5555
Fax: (217) 545-2563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036072794 Illinois

Profile Details

NPI number 1417943937
LBN Legal business name Hodgson, Kim J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Oct 16th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417943937 NPPES
Illinois MEDICAID 036072794

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