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NPI Code Detail

MEDICARE: DR. GEORGE R DUQUETTE M.D., F.A.C.S

MEDICARE: DR. GEORGE R DUQUETTE M.D., F.A.C.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist10194AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110679OTHERALBC/BS PROVIDER #

General Provider Information

NPI Number : 1386612729
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE R DUQUETTE M.D., F.A.C.S
Provider Business Mailing Address
First Line : 1990 SHADES CREST RD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35216-1414
Country : US
Telephone Number : 205-822-7009
Fax Number :
Provider Business Practice Location Address
First Line : 2022 BROOKWOOD MEDICAL CTR DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-6808
Country : US
Telephone Number : 205-877-2918
Fax Number : 205-877-2181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2006
Last Update Date : 03/04/2010

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