Provider Demographics
NPI:1154376333
Name:HUDSON, HENRY COLLIER (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:COLLIER
Last Name:HUDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HANK
Other - Middle Name:COLLIER
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 830230
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0230
Mailing Address - Country:US
Mailing Address - Phone:205-250-6000
Mailing Address - Fax:205-250-6848
Practice Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 510
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6808
Practice Address - Country:US
Practice Address - Phone:205-250-6061
Practice Address - Fax:205-250-8957
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7689208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000009619Medicaid
000009619Medicare PIN
ALC79075Medicare UPIN