Provider Demographics
NPI:1487810032
Name:GEORGE HUDSON, PA
Entity type:Organization
Organization Name:GEORGE HUDSON, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-366-8383
Mailing Address - Street 1:3030 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5107
Mailing Address - Country:US
Mailing Address - Phone:941-366-8383
Mailing Address - Fax:941-951-1485
Practice Address - Street 1:3030 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5107
Practice Address - Country:US
Practice Address - Phone:941-366-8383
Practice Address - Fax:941-951-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0001292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40804OtherBCBSFL
FL40844Medicare PIN