Provider Demographics
NPI:1922176510
Name:HUDGINS, JOHN STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STEPHEN
Last Name:HUDGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10 HICKOK STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073
Mailing Address - Country:US
Mailing Address - Phone:540-382-8316
Mailing Address - Fax:540-382-8317
Practice Address - Street 1:10 HICKOK STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-382-8316
Practice Address - Fax:540-382-8317
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101043527207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6325602Medicaid
054601OtherBCBS
054601OtherBCBS
VA6325602Medicaid