Provider Demographics
NPI:1003672767
Name:HUDGENS, ALVIN EDWARD JR
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:EDWARD
Last Name:HUDGENS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 57TH PL SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-6540
Mailing Address - Country:US
Mailing Address - Phone:240-927-3091
Mailing Address - Fax:
Practice Address - Street 1:151 Q ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2140
Practice Address - Country:US
Practice Address - Phone:202-297-1426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant