Guilford M Dudley, MD
Individual provider Active NPI Internal Medicine Physician · Newport, AR
NPI 1922054428 · NPPES record last updated Feb 24, 2012
Key facts
- NPI
- 1922054428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- R1908 (AR)
- Practice address
- 1200 McLain Street
Newport, AR 72112 - Phone
- (870) 523-5272
- Fax
- (870) 523-4292
- NPI assigned
- May 26, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1908 | AR | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | R1908 | AR | Yes |
Addresses
Primary practice location
1200 McLain Street
Newport, AR 72112
Mailing address
1200 McLain Street
Newport, AR 72112
Phone (870) 523-5272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102855002 | Medicaid | AR | |
| 4512788 | Other | AETNA | |
| 112083126 | Other | AR | RAILROAD MEDICARE |
Other providers in Newport, AR
- Jennifer L Dorris
- Brandy Douglas
- Shelia Dove
- Kelly Drye
- Samantha Jo Dubach
- Retha S Dudley
- Terri Dukes
- Madison Eddington
- Alyson D Edwards
- Jennifer Leann Elder
All providers in Newport, AR · Internal Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.