Provider Demographics
NPI:1174813554
Name:JUDSON, CHRISTOPHER HARRY (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:HARRY
Last Name:JUDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 BATTERSON PARK RD STE 107
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2565
Mailing Address - Country:US
Mailing Address - Phone:860-549-8276
Mailing Address - Fax:860-674-8084
Practice Address - Street 1:31 SEYMOUR STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-549-3210
Practice Address - Fax:860-247-3803
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9742281-1205207X00000X
CT56169207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT56169OtherORTHOPEDICS