Healthcare Provider Details

I. General information

NPI: 1285564476
Provider Name (Legal Business Name): MASON HUNTER DUKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 BROOKSTONE CENTRE PKWY STE 200
COLUMBUS GA
31904-9219
US

IV. Provider business mailing address

7401 BLACKMON RD APT 1706
COLUMBUS GA
31909-4493
US

V. Phone/Fax

Practice location:
  • Phone: 706-940-5677
  • Fax:
Mailing address:
  • Phone: 229-220-2412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: