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NPI Code Detail

MEDICARE: DONNA S JUDSON M.D.

MEDICARE:   DONNA S JUDSON  M.D.
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
1207Q00000XFamily Medicine PhysicianME 73208FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00461851OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
141382OTHERFLBLUE CROSS BLUE SHIELD FL
3591-97072OTHERALBCBS ALABAMA
4A196OTHERFLHEALTH FIRST NETWORK
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447230479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA S JUDSON M.D.
Provider Business Mailing Address
First Line : PO BOX 533
Second Line :
City : CANTONMENT
State : FL
Zip : 32533-0533
Country : US
Telephone Number : 850-476-0559
Fax Number : 850-476-0599
Provider Business Practice Location Address
First Line : 2400 S HIGHWAY 29
Second Line : STE 306
City : CANTONMENT
State : FL
Zip : 32533-5808
Country : US
Telephone Number : 850-476-0559
Fax Number : 850-476-0599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 01/21/2011

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Directions to “ DONNA S JUDSON M.D.” Practice Location

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