Organization
GREGORY HUDSON MD INC
Active
Organization
GREGORY HUDSON MD INC
Active
Other names
CHRIST CARE PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE HUNT (BILLING CREDENTIALING)
(606) 932-2079
Entity
Organization
Contact information
Practice address
137 STATE ROUTE 3117, SOUTH SHORE, KY 41175
(606) 932-2079
(606) 932-2313
Mailing address
137 STATE ROUTE 3117, SOUTH SHORE, KY 41175
(606) 932-2079
(606) 932-2313
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243927
—
OH
05
—
0433890
—
OH
01
—
36D0683301
CLIA
KY
01
—
36D2062943
CLIA
OH
05
—
7100373950
—
KY
05
—
7100373960
—
KY
05
—
7100724490
—
KY
01
—
K182002
PTAN
KY
Enumeration date
11/21/2006
Last updated
03/10/2021
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