Provider Demographics
NPI:1518023977
Name:DUDLEY, JAMES LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEE
Last Name:DUDLEY
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:2851 N TENAYA WAY
Mailing Address - Street 2:#103
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0435
Mailing Address - Country:US
Mailing Address - Phone:702-309-4878
Mailing Address - Fax:702-309-4879
Practice Address - Street 1:2900 N GREEN VALLEY PKWY
Practice Address - Street 2:SUITE 114
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0410
Practice Address - Country:US
Practice Address - Phone:702-798-7171
Practice Address - Fax:702-436-6561
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2015-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVB 373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV106773OtherPTAN
NVT67189Medicare UPIN