Individual
DR. STEPHEN ALBERT HUDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
169815-1
NY
207W00000X
Ophthalmology Physician
MD027486E
PA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
MD027486E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150040317
RR MEDICARE PIN
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039847
MEDICARE GROUP
PA
01
—
P00329050
RR MEDICARE PIN
NY
Enumeration date
03/09/2006
Last updated
04/02/2021
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