Provider Demographics
NPI:1528124203
Name:HUDOCK, JOHN F (AUDIOLOGIST)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:HUDOCK
Suffix:
Gender:M
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:800-328-8602
Mailing Address - Fax:
Practice Address - Street 1:137 FINLEY RD RM 307A
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1994
Practice Address - Country:US
Practice Address - Phone:724-489-9565
Practice Address - Fax:724-489-9566
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA237700000X
PAAT000297L237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA286890YM91OtherMEDICARE
PA286890YAUROtherMEDICARE