Hudson Dermatology, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

01029475A Issued in IN

Legal business name

HUDSON DERMATOLOGY, PC

Practice address

3501 Washington Ave
Evansville, IN 47714-0538

Phone

(812) 474-1234

Fax

(812) 402-3636

NPI assigned

Nov 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles P Hudson

Title

Owner

Phone

(812) 474-1234

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1578744181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140538",
            "telephone_number": "812-474-1234",
            "fax_number": "812-402-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140538",
            "telephone_number": "812-474-1234",
            "fax_number": "812-402-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-474-1234",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01029475A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000079535",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00134400",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "0000000317128",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1023595",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hubert Family Dentistry LLP
• Adam David Hubert, D.D.S.
• David Michael Hubert, DDS
• Tracy Amber Huck, BSW
• Danielle M. Hudak, R.N.
• Charles P Hudson, M.D.
• Jessica Ashley Hudson, PTA
• Jossie Marie Hudson, DPT
• Michael Hudson II, PHARMD
• Bethany J Huebner, DPT

• Specialist in Evansville, IN
• Providers in Evansville, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.