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General NPI Number Information
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NPI Number | 1255396883
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Entity Type | Organization
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Legal Business Name | DUKES PHYSICIAN SERVICES LLC
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 275 W 12TH ST
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City | PERU
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State | IN
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Zip | 46970-1638
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Country | US
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Telephone | 765-472-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 N BROADWAY
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City | PERU
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State | IN
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Zip | 46970-1070
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Country | US
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Telephone | 765-472-5335
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/PROVIDER ENROLLMENT
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Name | KRISTINA MUSIC
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Credential |
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Telephone | 615-465-7377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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