Provider Demographics
NPI:1497018329
Name:HODGES, LAURA ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELAINE
Last Name:HODGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-3077
Mailing Address - Country:US
Mailing Address - Phone:401-691-6000
Mailing Address - Fax:401-738-7718
Practice Address - Street 1:2756 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3077
Practice Address - Country:US
Practice Address - Phone:401-691-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-014102084P0800X
RIMD151002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNNB583AOtherPTAN
NC1497018329Medicaid
NCNNB5830299OtherPTAN (PSYCHIATRY)