Provider Demographics
NPI:1689614828
Name:HUDSON, HILTON M II (MD)
Entity Type:Individual
Prefix:DR
First Name:HILTON
Middle Name:M
Last Name:HUDSON
Suffix:II
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:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:3500 FRANCISCAN WAY STE 400
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-0021
Practice Address - Country:US
Practice Address - Phone:219-878-8200
Practice Address - Fax:219-877-8331
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44428208G00000X
IN01057771A208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000001005945OtherANTHEM PROVIDER NUMBER
IL01618941OtherBC/BS OF IL
IL036089208Medicaid
IN200441260Medicaid
IL211578003OtherMEDICARE PROVIDER
IN200441260Medicaid
IN522600Medicare PIN
IL211578003OtherMEDICARE PROVIDER
IN264430396Medicare PIN