MEDICARE: DR. RYAN KENT HUDSON D.O.

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	20A9299	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669555447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN KENT HUDSON D.O.

Provider Business Mailing Address
First Line	:	13203 DA VINCI DR
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93314-6905
Country	:	US
Telephone Number	:	661-587-4066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 COLUMBUS ST
Second Line	:	SUITE 1200
City	:	BAKERSFIELD
State	:	CA
Zip	:	93305-1936
Country	:	US
Telephone Number	:	661-326-5018
Fax Number	:

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	12/02/2021

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