Individual
BRYAN K HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1700 W STOUT ST, RICE LAKE, WI 54868-5000
(715) 236-8104
Mailing address
920 N SHADELAND AVE, SUITE G1, INDIANAPOLIS, IN 46219-4817
(317) 355-9783
(317) 355-9760
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000874A
IN
363A00000X
Physician Assistant
1632
WI
363A00000X
Physician Assistant
50.005985RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360999
—
OH
Enumeration date
10/06/2006
Last updated
11/06/2024
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