Provider Demographics
NPI:1558393173
Name:HUDSON, ALISSA CRAFT (MD)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:CRAFT
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:ANNE
Other - Last Name:CRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:600 E VETERANS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-4038
Mailing Address - Country:US
Mailing Address - Phone:931-372-1994
Mailing Address - Fax:931-372-9045
Practice Address - Street 1:600 E VETERANS DR
Practice Address - Street 2:SUITE A
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4038
Practice Address - Country:US
Practice Address - Phone:931-372-1994
Practice Address - Fax:931-372-9045
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000040781207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology