Healthcare Provider Details

I. General information

NPI: 1750722641
Provider Name (Legal Business Name): GEORGE FRANCIS HUDSON RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 BEE ST
CHARLESTON SC
29401-5703
US

IV. Provider business mailing address

1324 CENTER LAKE DR.
MT. PLEASANT SC
29464
US

V. Phone/Fax

Practice location:
  • Phone: 843-789-7217
  • Fax:
Mailing address:
  • Phone: 843-789-7217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: