Hudson, Larry David

Hudson, Larry David is an individual health care provider with primary practice located at 1021 W Oakland Ave Suite 102, Johnson City TN 37604-2191. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Hudson, Larry David can be contacted via phone (423) 928-9014.

Contact Information

Primary practice address
1021 W Oakland Ave Suite 102 Johnson City TN 37604-2191
Phone: (423) 928-9014
Fax: (423) 928-9014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD0000013019 Tennessee

Profile Details

NPI number 1679564835
LBN Legal business name Hudson, Larry David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679564835 NPPES
Other TN0101 JOHN DEERE HEALTHCARE
MEDICAID 3701830 JOHN DEERE HEALTHCARE
Other 0036521 JOHN DEERE HEALTHCARE

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