| Name: | David W. Hodo, M.D., P.A. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Association |
| Status: | Exists |
| Date of registration: | 03 Jun 1980 (44 years ago) (Companies founded in June 1980) |
| Entity Number: | 000-061-443 |
| Register Number: | 000061443 |
| ZIP code: | 36701 (Companies in Dallas, 36701) |
| County: | Dallas |
| Place of Formation: | Dallas County |
| Principal Address: | 800 TREMONT STREETSELMA, AL 36701 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679836878 | 2012-06-21 | 2012-06-21 | P.O. BOX 1334, 800 TREMONT STREET, SELMA, AL, 367021334, US | 800 TREMONT STREET, SELMA, AL, 367015447, US | |||||||||||||||||||||||||||||
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| Phone | +1 334-872-6773 |
| Fax | 3348746257 |
Authorized person
| Name | MR. DAVID W. HODO |
| Role | PRESIDENT/M.D./PHYSICIAN |
| Phone | 3348726773 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | 00005987 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 510-02950 |
| Issuer | MEDICAID |
| Number | 000002950 |
| State | AL |
| Name | Role |
|---|---|
| HODO, DAVID | Member |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
