Healthcare Provider Details

I. General information

NPI: 1609803535
Provider Name (Legal Business Name): JAMES B DUKE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 SE 17TH ST SUITE 500
OCALA FL
34471-9107
US

IV. Provider business mailing address

2300 SE 17 STREET SUITE 500
OCALA FL
34471-9107
US

V. Phone/Fax

Practice location:
  • Phone: 352-867-0444
  • Fax: 352-867-5522
Mailing address:
  • Phone: 352-867-0444
  • Fax: 352-867-5522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0048787
License Number StateFL

VIII. Authorized Official

Name: LISA MAYNE
Title or Position: BILLING DIRECTOR
Credential:
Phone: 352-867-0444