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General NPI Number Information
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NPI Number | 1508162702
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Entity Type | Organization
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Legal Business Name | HUDAK FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 3246 US ROUTE 60 STE 5
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City | HUNTINGTON
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State | WV
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Zip | 25705-2729
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Country | US
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Telephone | 304-733-5990
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Fax | 304-733-5991
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Provider Business Mailing Address
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Address Line | 3246 US ROUTE 60 STE 5
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City | HUNTINGTON
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State | WV
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Zip | 25705-2729
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Country | US
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Telephone | 304-733-5990
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Fax | 304-733-5991
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Authorized Official
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Title or Position | OWNER
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Name | JASON A HUDAK
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Credential | MD
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Telephone | 304-733-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 22791
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License Number State | WV
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