Provider Demographics
NPI:1740208206
Name:TAYLOR, HUDSON G (PHD)
Entity Type:Individual
Prefix:
First Name:HUDSON
Middle Name:G
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2639
Mailing Address - Country:US
Mailing Address - Phone:614-722-2000
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2639
Practice Address - Country:US
Practice Address - Phone:614-722-4700
Practice Address - Fax:614-722-4718
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.4058103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH680001710OtherRAILROAD MEDICARE
OHP00333039OtherRAILROAD MEDICARE
OH000000221378OtherUNISON
OH7697545OtherAETNA
OHP00420613OtherRAILROAD MEDICARE
OH364074OtherWELLCARE
OH0716587Medicaid
OH473369000OtherMAGELLAN
OH000000028299OtherANTHEM
OH000000526162OtherANTHEM
OH716587OtherBCMH
OH364074OtherWELLCARE
OH7697545OtherAETNA
OH000000526162OtherANTHEM
OHTACP21152Medicare PIN