Healthcare Provider Details

I. General information

NPI: 1770784191
Provider Name (Legal Business Name): ANGELA RENEE LIPSCOMB-HUDSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA RENEE LIPSCOMB

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 W NC HIGHWAY 54 STE 405
DURHAM NC
27707-5599
US

IV. Provider business mailing address

1502 W NC HIGHWAY 54 STE 405
DURHAM NC
27707-5599
US

V. Phone/Fax

Practice location:
  • Phone: 614-214-6029
  • Fax:
Mailing address:
  • Phone: 614-214-6029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number125054432
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number2011-00898
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2011-00898
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: