Jay Hudnall

Individual provider Active NPI Occupational Therapist · Summit, MS

NPI 1750673158 · NPPES record last updated May 4, 2011

Key facts

NPI
1750673158
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT1203 (MS)
Practice address
4109 Highway 98 W
Summit, MS 39666-9132
Phone
(601) 276-3900
NPI assigned
May 4, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OT1203MSMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT1203 MS Yes

Addresses

Primary practice location

4109 Highway 98 W
Summit, MS 39666-9132

Mailing address

4109 Highway 98 W
Summit, MS 39666-9132

Other providers in Summit, MS

All providers in Summit, MS · Occupational Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.