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General NPI Number Information
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NPI Number | 1861479354
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Entity Type | Individual
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Provider Name | BILLY LEE DUKE II MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 225 WAYNE AVE
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City | INDIALANTIC
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State | FL
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Zip | 32903-3149
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Country | US
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Telephone | 321-615-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 225 WAYNE AVE
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City | INDIALANTIC
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State | FL
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Zip | 32903-3149
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Country | US
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Telephone | 321-615-1744
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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 | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD35803
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME102267
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License Number State | FL
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