Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 69053 | GA |
N | 207VG0400X | Gynecologist | 69053 | GA |
NPI | 1275777922 |
---|---|
Provider Name | Catherine Hudson |
First Address | Acworth, GA 30101-4112 |
Second Address | Acworth, GA 30101-4112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2009 |
Last Update Date | 15/04/2021 |