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General NPI Number Information
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NPI Number | 1538656822
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Entity Type | Individual
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Provider Name | ANTHONY THOMAS DUPUY III DO
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Gender | Male
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 2001 KINGSLEY AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-5148
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Country | US
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Telephone | 904-639-2015
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 KEATS DR APT 1535
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City | SPARTANBURG
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State | SC
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Zip | 29301-4986
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Country | US
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Telephone | 904-315-9344
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS17944
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License Number State | FL
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