Organization
HUDSON DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES P HUDSON (OWNER)
(812) 474-1234
Entity
Organization
Contact information
Practice address
3501 WASHINGTON AVE, EVANSVILLE, IN 47714-0538
(812) 474-1234
(812) 402-3636
Mailing address
3501 WASHINGTON AVE, EVANSVILLE, IN 47714-0538
(812) 474-1234
(812) 402-3636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01029475A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000317128
ANTHEM BCBS
IN
01
—
000000079535
ANTHEM
IN
01
—
1023595
TRICARE
IN
01
—
P00134400
RR MEDICARE
IN
Enumeration date
11/26/2007
Last updated
02/27/2008
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