Individual
DR. ROY ADRAIN HUDSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
516 VANCE AVE, MEMPHIS, TN 38126-2117
(901) 526-4442
(901) 526-8523
Mailing address
516 VANCE AVE, MEMPHIS, TN 38126-2117
(901) 526-4442
(901) 526-8523
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS0000007059
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004699
TENNCARE PROVIDER NUMBER
TN
05
—
3202421
—
TN
Enumeration date
12/14/2005
Last updated
06/18/2008
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