Provider Demographics
NPI:1588643563
Name:HUDSON, THOMAS FLOYD III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FLOYD
Last Name:HUDSON
Suffix:III
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 1:9 MEDICAL LANE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034
Mailing Address - Country:US
Mailing Address - Phone:501-327-8480
Mailing Address - Fax:501-327-2854
Practice Address - Street 1:9 MEDICAL LANE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034
Practice Address - Country:US
Practice Address - Phone:501-327-8480
Practice Address - Fax:501-327-2854
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR2661207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105042001Medicaid
AR52512C633Medicare PIN
ARD84169Medicare UPIN