Provider Demographics
NPI:1255370029
Name:HODGE, ROGER A (MD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:A
Last Name:HODGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-4088
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:5700 TEMPLE RD STE 201
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4223
Practice Address - Country:US
Practice Address - Phone:629-208-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4116585OtherAETNA
TN813016OtherUNITED HEALTH CARE
TN110237380OtherMEDICARE RR
TN01047197OtherAMERIGROUP TENNCARE
TN258562OtherUSA MANAGED CARE
KY64911563Medicaid
TN1508026Medicaid
TN1550164OtherCIGNA PPO/POS
TNQ006397Medicaid
TN1058211OtherCOVENTRY/FIRST HEALTH
TN12078788OtherMULTIPLAN/PHCS
TN4038071OtherBLUE CROSS OF TN
TN11006437OtherGEHA
TN110237380OtherMEDICARE RR
TNQ006397Medicaid