KEVIN R DUKE, DO, PC NPI 1003001959

Clinic/Center (Health Service) in Providence, UT

Organization Clinic/Center Health Service

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 NameKEVIN R DUKE, DO, PC
Provider Location Address382 W 280 N PROVIDENCE, UT 84332
Provider Mailing AddressPO BOX 609 PROVIDENCE, UT 84332
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-12-2007
Last Update Date12-02-2011

Primary Taxonomy

Taxonomy Code261QH0100X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationHealth Service
License No.290545-1204
License StateUT

Business Address

KEVIN R DUKE, DO, PC
382 W 280 N
PROVIDENCE, UT
ZIP 84332
Phone: (435) 752-0330
Fax: (435) 755-0922

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Mailing Address

KEVIN R DUKE, DO, PC
PO BOX 609
PROVIDENCE, UT
ZIP 84332
Phone: (435) 752-0330
Fax: (435) 755-0922

Authorized Official

Authorized Official NameDR. KEVIN R DUKE D.O.
Authorized Official TitleOWNER
Authorized Official Phone(435) 752-0330

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
000057025MEDICARE PIN (08)UT
H67056MEDICARE UPIN (02)UT

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003882713DR. KEVIN R DUKE D.O.
Individual
Family Medicine382 W 280 N
PROVIDENCE, UT 84332
(435) 752-0330
1093154031JAMES DENNIS MATHEWS, D.O., P.C.
Organization
Clinic/Center (Health Service)382 W 280 N
PROVIDENCE, UT 84332
(435) 752-0330
1265424741DR. LAYNE S BARNES DO
Individual
Family Medicine382 W 280 N
PROVIDENCE, UT 84332
(435) 752-0330
1497721195DR. LARS BERGESON M.D.
Individual
Family Medicine382 W 280 N
PROVIDENCE, UT 84332
(435) 752-0330
1790739449DR. RICHARD T STEVENS M.D.
Individual
Family Medicine382 W 280 N
PROVIDENCE, UT 84332
(435) 752-0330
1982933750LARS BERGESON, M.D., PC
Organization
Point of Service382 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.