Individual
JASON RICHARD HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1072 GARY DR, COLUMBUS, OH 43207-4272
(614) 317-6766
Mailing address
1072 GARY DR, COLUMBUS, OH 43207-4272
(614) 317-6766
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RU665333
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114606670
—
OH
Enumeration date
07/12/2023
Last updated
07/16/2023
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