NPI 1023369501

Mario Donald Hodge, CPED

Practitioner Pedorthist Mount Vernon, IL

Practice location

Address: 1024 Jordan St, Mount Vernon, IL 62864-4231
Phone: (618) 242-4442
Fax: (618) 242-3942

Registered specialties

Pedorthist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224L00000X Licence 212.000161 (IL)

Other Pedorthist providers in Illinois →

Registry record

NPI: 1023369501
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Sep 2012
Record last updated: 25 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.