Provider Demographics
NPI:1780788802
Name:JUDD, THOMAS ELVIN (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ELVIN
Last Name:JUDD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10 HOSPITAL DR
Mailing Address - Street 2:STE 105
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040
Mailing Address - Country:US
Mailing Address - Phone:413-533-0451
Mailing Address - Fax:413-535-1275
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:STE 105
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-533-0451
Practice Address - Fax:413-535-1275
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA49211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0160849Medicaid