Basic Information
| Provider Information | |||||||||
| NPI: | 1992294441 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUDSON | ||||||||
| FirstName: | TAYLOR | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 405 N MULBERRY ST APT 318 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176032925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027403356 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 HIGHLANDS DR | ||||||||
| Address2: | |||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175437694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176255000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2018 | ||||||||
| LastUpdateDate: | 06/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OT018243 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | OS020309 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.