Healthcare Provider Details

I. General information

NPI: 1467149229
Provider Name (Legal Business Name): TAYLOR JEAN DUKEMAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 S CENTERVILLE RD
LANCASTER PA
17603-9733
US

IV. Provider business mailing address

175 S CENTERVILLE RD
LANCASTER PA
17603-9733
US

V. Phone/Fax

Practice location:
  • Phone: 717-299-4644
  • Fax: 717-390-2916
Mailing address:
  • Phone: 717-299-4644
  • Fax: 717-390-2916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS026010
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: