Healthcare Provider Details

I. General information

NPI: 1710374194
Provider Name (Legal Business Name): CATHERINE TRIDICO HUDSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 TUDOR AVE
NEW ORLEANS LA
70123-1346
US

IV. Provider business mailing address

1542 TULANE AVE
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 225-266-6968
  • Fax:
Mailing address:
  • Phone: 504-568-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number308856
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number308865
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number308865
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: