Organization
PONTCHARTRAIN PATHOLOGY APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY HUDSON MD (PRESIDENT)
(985) 649-8802
Entity
Organization
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(985) 649-8802
Mailing address
PO BOX 54930, NEW ORLEANS, LA 70154-4930
(985) 785-2221
(785) 785-1118
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441881
—
LA
Enumeration date
08/18/2005
Last updated
08/22/2020
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