James Dudley, A.T.C. Licensed
Specialist/Technologist, Athletic Trainer in Durant, OK. Individual provider (NPI-1).
NPI number1962606293
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1962606293
- Entity type
- Individual (NPI-1)
- Name
- Mr. James Dudley
- Credential
- A.T.C. Licensed
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 12, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 414 | OK | Yes |
Practice location
1405 N 4th AvePmb 4166
Durant, OK 74701-3330
Phone 580-745-3028 · Fax 580-745-7493
Mailing address
94 Eagle Loop DriveDurant, OK 74701-0609
Phone 580-924-2124 · Fax 580-745-7493
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 8 Athletic Trainer providers in Durant · All 1,274 providers in Durant
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