Active NPI
Duddleston Management, LLC
- Internal Medicine Physician
- Jackson, MS
National Provider Identifier
1154876290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- DUDDLESTON MANAGEMENT, LLC
- Practice address
- 1116 Forest Ave
Jackson, MS 39206-3216 - Phone
- (601) 291-1993
- NPI assigned
- Aug 18, 2016
- Last updated
- Aug 18, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Duddleston, MD
- Title
- Owner
- Phone
- (601) 291-1993
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1116 Forest Ave
Jackson, MS 39206-3216
Mailing address
PO Box 9178
Russellville, AR 72811-9178
Phone (479) 498-6700
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Madison, MS
- NPI 1003840539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1471478400000",
"number": "1154876290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9178",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728119178",
"telephone_number": "479-498-6700",
"fax_number": "479-968-4331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 FOREST AVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392063216",
"telephone_number": "601-291-1993"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DUDDLESTON MANAGEMENT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-08-18",
"last_updated": "2016-08-18",
"status": "A",
"authorized_official_last_name": "DUDDLESTON",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "601-291-1993",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.