Provider Demographics
NPI:1629017082
Name:DUDLEY, ROBBIE F (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBBIE
Middle Name:F
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:21 HUGHES RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3039
Mailing Address - Country:US
Mailing Address - Phone:256-772-2037
Mailing Address - Fax:256-772-9523
Practice Address - Street 1:21 HUGHES RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3039
Practice Address - Country:US
Practice Address - Phone:256-772-2037
Practice Address - Fax:256-772-9523
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL17499208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051096783OtherBLUE CROSS & BLUE SHIELD
ALE67005Medicare UPIN