Basic Information
| Provider Information | |||||||||
| NPI: | 1003801333 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HODDINOTT | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | MARCELL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3130 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344783130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3528678311 | ||||||||
| FaxNumber: | 3528671053 | ||||||||
| Practice Location | |||||||||
| Address1: | 1511 SW 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344716505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523681661 | ||||||||
| FaxNumber: | 3528679794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 09/23/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD0578081 | PA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 35-06-2777 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | ME100609 | FL | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0129X | ME100609 | FL | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 281126000 | 05 | FL | MEDICAID | 29763 | 01 | FL | BCBS | OTHER |