Provider Demographics
NPI:1326141359
Name:DUDLEY, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:DUDLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1135 E HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-1208
Mailing Address - Country:US
Mailing Address - Phone:970-824-1088
Mailing Address - Fax:970-824-2700
Practice Address - Street 1:1475 PINE GROVE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8803
Practice Address - Country:US
Practice Address - Phone:970-879-0203
Practice Address - Fax:970-879-1389
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2014-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO18625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO080085877OtherRAILROAD MEDICARE
CO01186253Medicaid
COC69454Medicare PIN
CO01186253Medicaid
CO080085877OtherRAILROAD MEDICARE