Healthcare Provider Details

I. General information

NPI: 1447207360
Provider Name (Legal Business Name): WILLIAM B HUDGINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MEMORIAL DR
PINEHURST NC
28374-8707
US

IV. Provider business mailing address

30 MEMORIAL DR
PINEHURST NC
28374-8707
US

V. Phone/Fax

Practice location:
  • Phone: 910-295-4400
  • Fax: 910-295-2810
Mailing address:
  • Phone: 910-295-4400
  • Fax: 910-295-2810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number9901207
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier12430
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerBCBS NC
# 2
Identifier8912430
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: