MEDICARE: DR. JOHN BUFORD HUDSON JR. MD

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
1	207Q00000X	Family Medicine Physician	ME023144	FL

General Provider Information

NPI Number	:	1376549634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN BUFORD HUDSON JR. MD

Provider Business Mailing Address
First Line	:	2071 DUNDEE DR
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4104
Country	:	US
Telephone Number	:	407-628-4188
Fax Number	:	407-740-8688

Provider Business Practice Location Address
First Line	:	2071 DUNDEE DR
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4104
Country	:	US
Telephone Number	:	407-628-4188
Fax Number	:	407-740-8688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	01/27/2011

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