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General NPI Number Information
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NPI Number | 1952476335
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Entity Type | Organization
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Legal Business Name | GREGORY HUDSON MD INC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 137 STATE ROUTE 3117
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City | SOUTH SHORE
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State | KY
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Zip | 41175
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Country | US
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Telephone | 606-932-2079
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Fax | 606-932-2313
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Provider Business Mailing Address
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Address Line | 137 STATE ROUTE 3117
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City | SOUTH SHORE
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State | KY
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Zip | 41175
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Country | US
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Telephone | 606-932-2079
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Fax | 606-932-2313
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Authorized Official
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Title or Position | BILLING CREDENTIALING
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Name | CHRISTINE HUNT
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Credential |
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Telephone | 606-932-2079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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