Gary W Hudson, D.M.D., M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

12133 Issued in AL

Practice address

1105 Eagletree LN SE
Huntsville, AL 35801-6447

Phone

(256) 882-7873

Fax

(256) 882-7874

NPI assigned

Apr 14, 2006

Last updated

Oct 12, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gary W. Hudson, DMD, MD, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntsville, AL
  • NPI 1932325677
  Authorized official Same address or phone
• Madison Oral and Facial Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Madison, AL
  • NPI 1346576915
  NPD (past)
• S. Clint Hudson, D.M.D., M.D., L.L.C.

  dba S. Clint Hudson, D.M.D., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntsville, AL
  • NPI 1164448320
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255305600000",
    "number": "1447214424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 EAGLETREE LN SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016447",
            "telephone_number": "256-882-7873",
            "fax_number": "256-882-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 EAGLETREE LN SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016447",
            "telephone_number": "256-882-7873",
            "fax_number": "256-882-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "GARY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2009-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "3677",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "12133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "720892",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHLAND",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIL HANDLERS",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERITAS",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "51000927",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAMCI",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008606360",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JARDINES",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METLIFE",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DENTAL",
            "identifier": "760775732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GUARDIAN",
            "identifier": "760775732",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Howard Hubert, PT
• Walter John Hubickey, D.O.
• Lindy April Hudgins, COTA/L
• Ashley Alane Hudson, M.D.
• Frances M Hudson, PHARMD
• Steven Clint Hudson, DMD, MD
• Hudsonalpha Clinical Services Lab LLCC
• Brittany Taylor Huey, LCSW
• Joshua Huff, DMD
• Whitney Esdale Huff, PA

• Oral & Maxillofacial Surgery (D.M.D.) in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.