Provider Demographics
NPI:1285641746
Name:DUDNEY, TINA MAUREEN (MD)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MAUREEN
Last Name:DUDNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 ALCOA HWY
Mailing Address - Street 2:SUITE E-210
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-2244
Mailing Address - Country:US
Mailing Address - Phone:865-524-7471
Mailing Address - Fax:865-305-6563
Practice Address - Street 1:1940 ALCOA HWY
Practice Address - Street 2:SUITE E-210
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-2244
Practice Address - Country:US
Practice Address - Phone:865-524-7471
Practice Address - Fax:865-305-6563
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20523207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG12385Medicare UPIN