Provider Demographics
NPI:1275999476
Name:ANDREA B. HUDSON, OD, LLC
Entity Type:Organization
Organization Name:ANDREA B. HUDSON, OD, LLC
Other - Org Name:STEEL CITY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:BEAVERS
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-447-6774
Mailing Address - Street 1:2937 7TH AVENUE SOUTH, #104
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233
Mailing Address - Country:US
Mailing Address - Phone:205-447-6774
Mailing Address - Fax:
Practice Address - Street 1:2937 7TH AVE S STE 104
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2927
Practice Address - Country:US
Practice Address - Phone:205-447-6774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-881-TA-462152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU71876Medicare UPIN