Basic Information
| Provider Information | |||||||||
| NPI: | 1104034156 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUDGINS | ||||||||
| FirstName: | LESLEE | ||||||||
| MiddleName: | EVANS | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3239 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295023239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433908310 | ||||||||
| FaxNumber: | 8433908319 | ||||||||
| Practice Location | |||||||||
| Address1: | 3980 HIGHWAY 9 E | ||||||||
| Address2: | SUITE 340 | ||||||||
| City: | LITTLE RIVER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295667832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433908310 | ||||||||
| FaxNumber: | 8433908319 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 02/09/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 1067 | SC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.