Healthcare Provider Details

I. General information

NPI: 1477400869
Provider Name (Legal Business Name): ERIN BEACH HUDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 E BROAD ST
COLUMBUS OH
43213-1562
US

IV. Provider business mailing address

524 GRAVES RD
CONWAY MA
01341-9784
US

V. Phone/Fax

Practice location:
  • Phone: 614-751-4070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.007492
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: