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General NPI Number Information
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NPI Number | 1215152368
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Entity Type | Organization
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Legal Business Name | WAYNE R. HUDSON, DO, INC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1134 HAGER ST
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City | SAINT MARYS
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State | OH
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Zip | 45885-2423
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Country | US
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Telephone | 419-394-4044
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Fax | 419-394-1655
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Provider Business Mailing Address
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Address Line | 1134 HAGER ST
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City | SAINT MARYS
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State | OH
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Zip | 45885-2423
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Country | US
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Telephone | 419-394-4044
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Fax | 419-394-1655
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WAYNE ROSS HUDSON
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Credential | DO
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Telephone | 419-394-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 6421
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 6421
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License Number State | OH
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