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General NPI Number Information
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NPI Number | 1811962046
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Entity Type | Individual
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Provider Name | ROBERT R HUDSON M.S.S., A.T.C.
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 806 SAINT VINCENTS DR
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1616
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Country | US
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Telephone | 205-939-1557
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Fax |
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Provider Business Mailing Address
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Address Line | 1006 IRVING RD
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3428
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Country | US
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Telephone | 205-870-9540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 864
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License Number State | AL
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