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NPI Code Detail

MEDICARE: DR. CHADWICK STEVEN HUDNALL OD

MEDICARE: DR. CHADWICK STEVEN HUDNALL OD
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
1152W00000XOptometrist1239NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11239OTHERNESTATE LICENSE NUMBER

General Provider Information

NPI Number : 1245297860
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHADWICK STEVEN HUDNALL OD
Provider Business Mailing Address
First Line : 401 N EDDY ST
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-4558
Country : US
Telephone Number : 308-384-6922
Fax Number : 308-384-7824
Provider Business Practice Location Address
First Line : 401 N EDDY ST
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-4558
Country : US
Telephone Number : 308-384-6922
Fax Number : 308-384-7824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 11/15/2007

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