Provider Demographics
NPI:1407805260
Name:HOBBS, HUDNER L (MD)
Entity Type:Individual
Prefix:DR
First Name:HUDNER
Middle Name:L
Last Name:HOBBS
Suffix:
Gender:F
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:PO BOX 301077
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46230-1077
Mailing Address - Country:US
Mailing Address - Phone:317-439-2510
Mailing Address - Fax:
Practice Address - Street 1:3850 SHORE DR
Practice Address - Street 2:SUITE 315
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5621
Practice Address - Country:US
Practice Address - Phone:317-387-4219
Practice Address - Fax:317-293-3991
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01020807A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100055710AMedicaid
IN000000086646OtherANTHEM
IN200338240Medicaid
IN200338240Medicaid