Provider Demographics
NPI:1487920583
Name:DUDLEY, WILLIAM D SR
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:DUDLEY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8444 MELBOURNE CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8976
Mailing Address - Country:US
Mailing Address - Phone:334-669-6340
Mailing Address - Fax:
Practice Address - Street 1:8444 MELBOURNE CIR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-8976
Practice Address - Country:US
Practice Address - Phone:334-669-6340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist