Individual
REUBEN GUY HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FAAP
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-6196
(208) 381-6199
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
MD00048852
WA
208800000X
Urology Physician
MD25800
OR
2088P0231X
Pediatric Urology Physician
Primary
7161277
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213391
—
OR
05
—
8425738
—
WA
Enumeration date
08/03/2006
Last updated
10/11/2024
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