Doctor Name: | SHERMAN G DUDLEY |
NPI Number: | 1073846127 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 119 Nancy Cox Dr Suite 2 Campbellsville, KY - 427186832 |
Business Phone Number: | 2704650575 |
Business Fax Number: | 2704650577 |
Mailing Address: | 119 Nancy Cox Dr, Suite 2 CAMPBELLSVILLE |
State: | KY |
Postal Code: | 427186832 |
Phone Number: | 2704650575 |
Fax Number: | 2704650577 |
NPI Enumeration Date: | 09/08/2009 |
NPI Last Update Date: | 09/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1744P3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | Prosthetics Case Management |
Taxonomy Definition: |