Individual
DR. RANDALL B HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-7940
(816) 932-7957
Mailing address
PO BOX 504407, SAINT LOUIS, MO 63150-4407
(816) 932-7940
(816) 932-7957
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R7H25
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000332
MO FHP PROVIDER NUMBER
MO
05
—
100119200C
—
MO
01
—
14018080
MO BCBS PROVIDER NUMBER
MO
01
—
2010016523
MO LICENSE
MO
05
—
202582664
—
MO
Enumeration date
05/17/2006
Last updated
01/20/2014
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