| Gary W. Hudson, Dmd, Md, Pc | |
|
1105 Eagletree Ln Se Huntsville AL 35801-6447 | |
| (256) 882-7873 | |
| (256) 882-7874 |
| Full Name | Gary W. Hudson, Dmd, Md, Pc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 1105 Eagletree Ln Se, Huntsville, Alabama |
| Authorized Official Name and Position | Gary Wayne Hudson (PRESIDENT) |
| Authorized Official Contact | 2568827873 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary W. Hudson, Dmd, Md, Pc 1105 Eagletree Ln Se Huntsville AL 35801-6447 Ph: (256) 882-7873 | Gary W. Hudson, Dmd, Md, Pc 1105 Eagletree Ln Se Huntsville AL 35801-6447 Ph: (256) 882-7873 |
| NPI Number | 1932325677 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7012958010 |
|---|---|
| Medicare Enrollment ID | O20050519000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932325677 | NPI | - | NPPES |
| 51000927 | Other | AL | BLUE CROSS BLUE SHIELD AL |
| 720892 | Other | AL | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 3677 (Alabama) | Primary |
| 204E00000X | Oral & Maxillofacial Surgery | 12133 (Alabama) | Primary |
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