Provider Demographics
NPI:1013278043
Name:DUDLEY, PAIGE (MD)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:DUDLEY
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 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-322-3476
Mailing Address - Fax:615-343-1763
Practice Address - Street 1:11101 DOCTOR'S OFFICE TOWER 2200 CHILDREN'S WAY
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-9544
Practice Address - Country:US
Practice Address - Phone:615-322-3476
Practice Address - Fax:615-343-1763
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
TN61323208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No171000000XOther Service ProvidersMilitary Health Care Provider