Provider Demographics
NPI:1063831352
Name:HUDSON, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:HUDSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2551 GREENWOOD RD STE 410
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3989
Mailing Address - Country:US
Mailing Address - Phone:318-621-2929
Mailing Address - Fax:318-638-3169
Practice Address - Street 1:2551 GREENWOOD RD STE 410
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3989
Practice Address - Country:US
Practice Address - Phone:318-621-2929
Practice Address - Fax:318-638-3169
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2023-01-27
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Provider Licenses
StateLicense IDTaxonomies
LA306145207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty