DUDLEY A HUDSPETH MD, NPI 1205835493 — CHANDLER (AZ)

NPI 1205835493

14+ Years Experience Individual

DUDLEY A HUDSPETH MD

07/19/2005
PROVIDER ENUMERATION DATE
01/16/2017
LAST UPDATE DATE
1205835493
NPI NUMBER

About DUDLEY A HUDSPETH

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

DUDLEY A HUDSPETH is a provider established in CHANDLER, AZ. The NPI number of DUDLEY A HUDSPETH is 1205835493 and was assigned on 07/19/2005. The practitioners primary taxonomy code is: 208600000X with license number: 32737 NC .

Mailing address

  • City: CHANDLER
  • State: AZ
  • Postal code: 852245600
  • Phone: 4804074999
  • Fax: 4804074998
  • Address: 485 S DOBSON RD
  • Address 2: STE 111

Primary Practice Address

  • Region : CHANDLER, AZ
  • NPI : 1205835493
  • Phone : 4804074999
  • Fax : 4804074998
  • Postalcode : 852245600
  • Address : 485 S DOBSON RD STE 111

Additional identifiers

  • Identifier: Z76591
  • Code / Type : 1 - other
  • Identifier state : AZ
  • Identifier issuer: GROUP PIN

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 320060
  • Code / Type : 5 - MEDICAID
  • Identifier state : AZ

Provider taxonomy - Surgery

  • Taxonomy code: 208600000X
  • License number: 32737
  • License state: NC

The taxonomy is not the primary taxonomy.

Taxonomy description: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Healthcare provider taxonomy #2 - Thoracic Surgery (Cardiothoracic Vascular Surgery)

  • Taxonomy code: 208G00000X
  • License number: 23299
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Contacts:

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  • DUDLEY A HUDSPETH MD
  • Address : 485 S DOBSON RD STE 111
  • Region : CHANDLER, AZ
  • NPI : 1205835493
  • Phone : 4804074999
  • Fax : 4804074998
  • Postalcode : 852245600

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address485 S DOBSON RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSTE 111
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCHANDLER
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code852245600
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number4804074999
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4804074998
The fax number associated with the location address of the provider being identified.
NPI1205835493
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1208600000X
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Provider Enumeration Date07/19/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated01/16/2017
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DUDLEY A HUDSPETH
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address485 S DOBSON RD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSTE 111
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameCHANDLER
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code852245600
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number4804074999
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number4804074998
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1208600000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Surgery
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Provider License Number 132737
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NC
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2208G00000X
Healthcare Provider Taxonomy 2Thoracic Surgery (Cardiothoracic Vascular Surgery)
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Provider License Number 223299
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2AZ
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1Z76591
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1AZ
Other Provider Identifier State #1
Other Provider Identifier Issuer 1GROUP PIN
Other Provider Identifier Issuer #1
Other Provider Identifier 2320060
Other Provider Identifier #2
Other Provider Identifier Type 25
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2AZ
Other Provider Identifier State #2
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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