Organization
QUAIL RIDGE FAMILY PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK C HUDSON D.O. (OWNER)
(229) 378-8110
Entity
Organization
Contact information
Practice address
1 DOCTORS PARK, CAIRO, GA 39828
(229) 378-8110
(229) 378-8109
Mailing address
1 DOCTORS PARK, CAIRO, GA 39828-3072
(229) 378-8110
(229) 378-8109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345982719A
—
GA
05
—
986982597A
—
GA
Enumeration date
04/07/2006
Last updated
07/05/2018
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