Provider Demographics
NPI:1306840376
Name:HUDZIK, PAUL F (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:HUDZIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2718
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-0718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:270 E STATE ST
Practice Address - Street 2:STE 120
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4309
Practice Address - Country:US
Practice Address - Phone:330-823-8452
Practice Address - Fax:330-823-8491
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-006856208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2084640Medicaid
G92289Medicare UPIN
OH2084640Medicaid