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 in Providence, UT. The NPI number assigned to this provider is 1003001959. The practitioner's primary taxonomy code is Clinic/Center (261QH0100X). The provider is registered as an organization and their NPI record was last updated 7 years ago.

NPI	1003001959 National Provider Indentifier (NPI) The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name	KEVIN R DUKE, DO, PC
Provider Location Address	382 W 280 N PROVIDENCE, UT 84332 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	PO BOX 609 PROVIDENCE, UT 84332 Provider mailing address The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity Type	Organization Entity type code The code describing the type of health care provider that is being assigned an NPI. 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).
Is Sole Proprietor?	N/A
Is Organization Subpart?	No What is a subpart? Subparts are the components and separate physical locations of organization health care providers. 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.
Enumeration Date	09-12-2007 Provider enumeration date The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date	12-02-2011 Last update date The date that a record was last updated or changed.

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

Primary Taxonomy

Taxonomy Code	261QH0100X 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.
Classification	Clinic/Center
Type	Ambulatory Health Care Facilities
Specialization	Health Service
License No.	290545-1204
License State	UT

Authorized Official

Authorized Official Name	DR. KEVIN R DUKE D.O. Authorized official name The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official Title	OWNER
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
000057025	MEDICARE PIN (08)	UT
H67056	MEDICARE UPIN (02)	UT

Map Location

KEVIN R DUKE, DO, PC address is 382 W 280 N PROVIDENCE, UT 84332

Other Providers at the same location

The following 5 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
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

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