Provider Demographics
NPI:1174662076
Name:HUDSPATH, DUANE E (DC)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:E
Last Name:HUDSPATH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5436 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-2829
Mailing Address - Country:US
Mailing Address - Phone:540-869-3034
Mailing Address - Fax:540-869-0195
Practice Address - Street 1:5436 MAIN ST
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-2829
Practice Address - Country:US
Practice Address - Phone:540-869-3034
Practice Address - Fax:540-869-0195
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000488Medicare ID - Type Unspecified