Individual
JEFFREY N GUDGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6000
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL27064
SC
208M00000X
Hospitalist Physician
Primary
27064
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316155112
GROUP NPI
SC
05
—
270646
—
SC
01
—
P01476309
RAILROAD MEDICARE
SC
Enumeration date
07/25/2006
Last updated
09/26/2016
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