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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