Individual
JERALD S DUDNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 S ARLINGTON AVE, SPRINGFIELD, OH 45505-1302
(937) 323-4350
(937) 364-4483
Mailing address
2121 E HIGH ST, SPRINGFIELD, OH 45505-1368
(937) 323-4350
(937) 323-7621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-06-6707
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
35-06-6707
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0968305
—
OH
Enumeration date
10/31/2006
Last updated
06/15/2018
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