Healthcare Provider Details

I. General information

NPI: 1891659314
Provider Name (Legal Business Name): HUDSON PHYSICIANS, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 MEMORIAL AVE N STE 200
STILLWATER MN
55082-1093
US

IV. Provider business mailing address

2651 HILLCREST DRIVE SUITE 303
STILLWATER WI
54016-4439
US

V. Phone/Fax

Practice location:
  • Phone: 715-531-6800
  • Fax: 715-531-6801
Mailing address:
  • Phone: 715-531-6800
  • Fax: 715-531-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MORGAN LEIGH BARNUM
Title or Position: MD/PRESIDENT
Credential:
Phone: 715-531-6800