Provider Demographics
NPI:1700830833
Name:HUDGINS, ROGER J (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:J
Last Name:HUDGINS
Suffix:
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 1:615 E PRINCETON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1435
Mailing Address - Country:US
Mailing Address - Phone:407-236-0006
Mailing Address - Fax:407-236-0007
Practice Address - Street 1:615 E PRINCETON ST STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1435
Practice Address - Country:US
Practice Address - Phone:407-236-0006
Practice Address - Fax:407-236-0007
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138199207T00000X
OH35.094337207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery