Healthcare Provider Details

I. General information

NPI: 1407805260
Provider Name (Legal Business Name): HUDNER L HOBBS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 SHORE DR SUITE 315
INDIANAPOLIS IN
46254-5621
US

IV. Provider business mailing address

PO BOX 301077
INDIANAPOLIS IN
46230-1077
US

V. Phone/Fax

Practice location:
  • Phone: 317-387-4219
  • Fax: 317-293-3991
Mailing address:
  • Phone: 317-439-2510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01020807A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: