KEVIN R DUKE, DO, PC NPI 1003001959
Clinic/Center (Health Service) in Providence, UT
About KEVIN R DUKE, DO, PC
Kevin R Duke, Do, Pc is a provider established in Providence, Utah specializing in clinic/center (health service) . The NPI number of Kevin R Duke, Do, Pc is 1003001959 and was assigned on September 2007. The practitioner's primary taxonomy code is 261QH0100X with license number 290545-1204 (UT). The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Dr. Kevin R Duke D.o. (Owner)
| NPI | 1003001959 |
| Provider Name | KEVIN R DUKE, DO, PC |
| Provider Location Address | 382 W 280 N PROVIDENCE, UT 84332 |
| Provider Mailing Address | PO BOX 609 PROVIDENCE, UT 84332 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 09-12-2007 |
| Last Update Date | 12-02-2011 |
Primary Taxonomy
| Taxonomy Code | 261QH0100X |
| Classification | Clinic/Center |
| Type | Ambulatory Health Care Facilities |
| Specialization | Health Service |
| License No. | 290545-1204 |
| License State | UT |
Business Address
KEVIN R DUKE, DO, PC
382 W 280 N
PROVIDENCE, UT
ZIP 84332
Phone: (435) 752-0330
Fax: (435) 755-0922
Mailing Address
KEVIN R DUKE, DO, PC
PO BOX 609
PROVIDENCE, UT
ZIP 84332
Phone: (435) 752-0330
Fax: (435) 755-0922
Additional Identifiers
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.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| 000057025 | MEDICARE PIN (08) | UT |
| H67056 | MEDICARE UPIN (02) | UT |
Other Providers at the same location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1003882713 | DR. KEVIN R DUKE D.O. Individual | Family Medicine | 382 W 280 N PROVIDENCE, UT 84332 (435) 752-0330 |
| 1093154031 | JAMES DENNIS MATHEWS, D.O., P.C. Organization | Clinic/Center (Health Service) | 382 W 280 N PROVIDENCE, UT 84332 (435) 752-0330 |
| 1144475674 | MOUNTAINSTAR MEDICAL GROUP- CACHE VALLEY, LLC Organization | Family Medicine | 382 W 280 N PROVIDENCE, UT 84332 (435) 752-0330 |
| 1265424741 | DR. LAYNE S BARNES DO Individual | Family Medicine | 382 W 280 N PROVIDENCE, UT 84332 (435) 752-0330 |
| 1497721195 | DR. LARS BERGESON M.D. Individual | Family Medicine | 382 W 280 N PROVIDENCE, UT 84332 (435) 752-0330 |
| 1790739449 | DR. RICHARD T STEVENS M.D. Individual | Family Medicine | 382 W 280 N PROVIDENCE, UT 84332 (435) 752-0330 |
| 1982933750 | LARS BERGESON, M.D., PC Organization | Point of Service | 382 W 280 N PROVIDENCE, UT 84332 (435) 752-0330 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The 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 Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type 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 (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.