Paul S Dudrick, MD

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

MD29501 Issued in TN

Practice address

1819 W Clinch Ave Ste 200
Knoxville, TN 37916-2435

Phone

(865) 524-3695

Fax

(865) 602-3528

NPI assigned

Oct 2, 2006

Last updated

Oct 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Surgical Oncology Associates

  • Surgical Oncology Physician
  • Knoxville, TN
  • NPI 1205921285
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1710070479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5675",
            "fax_number": "865-584-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W CLINCH AVE STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162435",
            "telephone_number": "865-524-3695",
            "fax_number": "865-602-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDRICK",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD29501",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TN",
            "license": "MD29501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3811235",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen James Duden, PHARM.D.
• Renee Michele Dudley
• Whitney Denise Dudley, CRNA
• Lydia Caroline Dudney, AU.D.
• Tina Maureen Dudney, MD
• Roxanne Sonia Dudrick
• Hannah Duff, RN
• Kara-Leigh Naomi Duff
• Mabrey Raymond Duff
• Jennifer Lynn Dugan, COTA/L

• Surgical Oncology Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Surgical Oncology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.