Individual
WADE L HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
2360 MULLAN RD, STE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-3907
Mailing address
2360 MULLAN RD, STE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-3907
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
273
MT
363AS0400X
Surgical Physician Assistant
Primary
273
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043788
—
MT
Enumeration date
06/09/2006
Last updated
08/26/2014
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