Dudley, Gary Edward
Dudley, Gary Edward is an individual health care provider with primary practice located at 2520 Windy Hill Rd Se Suite 203, Marietta GA 30067-8664. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Dudley, Gary Edward can be contacted via phone (770) 953-6401.Contact Information
Primary practice address
2520 Windy Hill Rd Se Suite 203
Marietta GA 30067-8664
Phone: (770) 953-6401
Fax: (770) 953-6015
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY000520 | Georgia |
Profile Details
| NPI number | 1710057294 |
|---|---|
| LBN Legal business name | Dudley, Gary Edward |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 9th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710057294 | NPPES |
| Georgia | MEDICAID | 000117961F | |
| Georgia | MEDICAID | 000117961A | |
| Georgia | MEDICAID | 000117961G | |
| Georgia | MEDICAID | 000117961H |
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