MEDICARE: WILLIAM D HUDSON 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	207L00000X	Anesthesiology Physician	01060191A	IN
2	207L00000X	Anesthesiology Physician	47720	KY
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	01060191A	IN
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	47720	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00279772	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000365467	OTHER	IN	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578504734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM D HUDSON MD

Provider Business Mailing Address
First Line	:	PO BOX 21890
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4115
Country	:	US
Telephone Number	:	502-907-0356
Fax Number	:	502-919-9780

Provider Business Practice Location Address
First Line	:	120 EXECUTIVE PARK
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4201
Country	:	US
Telephone Number	:	502-855-7200
Fax Number	:	502-855-7201

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	01/24/2023

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Directions to “ WILLIAM D HUDSON MD” Practice Location

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