Individual
JACK G HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7148 U S HIGHWAY 98, SUITE 101, HATTIESBURG, MS 39402-8577
(601) 261-1500
(601) 276-7549
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-1500
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09620
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00019293
—
MS
01
—
010027374
RAILROAD MEDICARE
—
01
—
1558913
AMERICAN ADMIN GROUP
MS
Enumeration date
08/18/2006
Last updated
07/08/2020
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