Provider Demographics
NPI:1730379561
Name:HODK PODIATRY, PC
Entity type:Organization
Organization Name:HODK PODIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HART
Authorized Official - Suffix:III
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-868-4300
Mailing Address - Street 1:2305 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-5009
Mailing Address - Country:US
Mailing Address - Phone:610-868-4300
Mailing Address - Fax:610-691-7624
Practice Address - Street 1:2305 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-5009
Practice Address - Country:US
Practice Address - Phone:610-868-4300
Practice Address - Fax:610-691-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002595L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA107374GPAMedicare PIN
PA198890GPAMedicare PIN
PA108566GPAMedicare PIN