Healthcare Provider Details

I. General information

NPI: 1346336583
Provider Name (Legal Business Name): LINDA W. DUKE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3102 BAY FRONT RD
MOBILE AL
36605-3629
US

IV. Provider business mailing address

PO BOX 50726
MOBILE AL
36605-0726
US

V. Phone/Fax

Practice location:
  • Phone: 251-533-5376
  • Fax: 251-478-9266
Mailing address:
  • Phone: 251-533-5376
  • Fax: 251-478-9266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number552
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: