Healthcare Provider Details

I. General information

NPI: 1528070331
Provider Name (Legal Business Name): JOSEPH PARKHILL DUDLEY DC LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2334 NORTH SCOTTSDALE ROAD SUITE A 130
SCOTTSDALE AZ
85257
US

IV. Provider business mailing address

2134 EAST BROADWAY UNIT 1032
TEMPE AZ
85282
US

V. Phone/Fax

Practice location:
  • Phone: 480-440-8750
  • Fax:
Mailing address:
  • Phone: 480-968-6205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0632
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7927
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberA31
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004
License Number StateNH
# 5
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number365
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: