Dudley, Jim
Dudley, Jim is an sole proprietor health care provider with primary practice located at 112 County 301 , Eureka Springs AR 72632-9192. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dudley, Jim can be contacted via phone (479) 445-0317.Contact Information
Primary practice address
112 County 301
Eureka Springs AR 72632-9192
Phone: (479) 445-0317
Fax: (479) 253-9479
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2261 | Arkansas |
Profile Details
| NPI number | 1730139692 |
|---|---|
| LBN Legal business name | Dudley, Jim |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2006 |
| Last updated | Feb 14th, 2014 - about 11 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 | 1730139692 | NPPES |
| Arkansas | MEDICAID | 104766722 | |
| Arkansas | Other | 410002993 |
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