Active NPI
Robert Jordan Hudson Sr., MD
- Developmental - Behavioral Pediatrics Physician
- Tulsa, OK
National Provider Identifier
1104151364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- 9204
- Practice address
- 4444 E 41St St
Tulsa, OK 74135-2527 - Phone
- (918) 619-4400
- Fax
- (918) 660-3631
- NPI assigned
- Oct 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9204 | OK | |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 9204 | OK | Primary |
Addresses
Primary practice location
4444 E 41St St
Tulsa, OK 74135-2527
Mailing address
PO Box 268838
Oklahoma City, OK 73126-8838
Phone (918) 660-3632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9204 | OK | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254787200000",
"number": "1104151364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 268838",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731268838",
"telephone_number": "918-660-3632",
"fax_number": "918-660-3631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 E 41ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741352527",
"telephone_number": "918-619-4400",
"fax_number": "918-660-3631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "ROBERT",
"middle_name": "JORDAN",
"name_suffix": "Sr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-06",
"last_updated": "2009-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "9204",
"primary": false
},
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "OK",
"license": "9204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.