Organization
GARY W. HUDSON, DMD, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY WAYNE HUDSON MD, DMD (PRESIDENT)
(256) 882-7873
Entity
Organization
Contact information
Practice address
1105 EAGLETREE LN SE, HUNTSVILLE, AL 35801-6447
(256) 882-7873
(256) 882-7874
Mailing address
1105 EAGLETREE LN SE, HUNTSVILLE, AL 35801-6447
(256) 882-7873
(256) 882-7874
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3677
AL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
12133
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51000927
BLUE CROSS BLUE SHIELD AL
AL
01
—
720892
UNITED CONCORDIA
AL
Enumeration date
04/18/2007
Last updated
09/11/2025
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