| S. Clint Hudson, D.m.d., M.d. | |
|
2317 Whitesburg Dr S Huntsville AL 35801-3819 | |
| (256) 533-1282 | |
| (256) 533-1288 |
| Full Name | S. Clint Hudson, D.m.d., M.d. |
|---|---|
| Speciality | Dentist |
| Location | 2317 Whitesburg Dr S, Huntsville, Alabama |
| Authorized Official Name and Position | S Clint Hudson (OWNER) |
| Authorized Official Contact | 2565331282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S. Clint Hudson, D.m.d., M.d. 2317 Whitesburg Dr S Huntsville AL 35801-3819 Ph: (256) 533-1282 | S. Clint Hudson, D.m.d., M.d. 2317 Whitesburg Dr S Huntsville AL 35801-3819 Ph: (256) 533-1282 |
| NPI Number | 1164448320 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 09/03/2013 |
| Medicare PECOS PAC ID | 7810992138 |
|---|---|
| Medicare Enrollment ID | O20060920000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164448320 | NPI | - | NPPES |
| 001858654 | Other | PA | UNITED CONCORDIA |
| 529928780 | Medicaid | AL | |
| K919 | Other | AL | MEDICARE |
| 51003400 | Other | AL | BLUECROSS BLUESHIELD AL |
| 4129232 | Other | TN | BLUECROSS BLUESHIELD TN |
| 51136356 | Other | AL | BLUECROSS BLUESHIELD AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5051 (Alabama) | Primary |
| Provider Name | Steven C Hudson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1629033824 PECOS PAC ID: 0042215378 Enrollment ID: I20060921000435 |
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