Most Relevant Information
Provider Data
| NPI Number: | 1003660853 |
| Provider Name: | SHANNON M HODGES |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/16/2024 |
| Last Updated: | 04/16/2024 |
Provider Practice Location
717 HIGHWAY 70 E
KINGSTON
OK
734398253
Practice Location Phone/Fax
| Phone: | 5807953794 |
| Fax: |
Provider Mailing Location
PO BOX 1003
KINGSTON
OK
734391003
Provider Mailing Phone/Fax
| Phone: | 5805652541 |
| Fax: |