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NPI Code Detail

MEDICARE: DR. GENEECO HUDSON DUKES D.C.

MEDICARE: DR. GENEECO HUDSON DUKES D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCHIR007294GA

General Provider Information

NPI Number : 1225020050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GENEECO HUDSON DUKES D.C.
Provider Business Mailing Address
First Line : 211 STALLION TRL
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-6731
Country : US
Telephone Number : 770-507-9592
Fax Number : 770-210-2450
Provider Business Practice Location Address
First Line : 147 NORTH PARK TRAIL
Second Line :
City : STOCKBRIDGE
State : GA
Zip : 30281-7373
Country : US
Telephone Number : 770-507-9592
Fax Number : 770-507-8047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 08/23/2007

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