MEDICARE: DR. STEVEN IRA DUKE D.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	6678	TN

General Provider Information

NPI Number	:	1487653028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN IRA DUKE D.PH.

Provider Business Mailing Address
First Line	:	116 S GAY ST
Second Line	:	SUITE 705
City	:	KNOXVILLE
State	:	TN
Zip	:	37902-1095
Country	:	US
Telephone Number	:	865-382-9876
Fax Number	:	865-922-1604

Provider Business Practice Location Address
First Line	:	6909 MAYNARDVILLE PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-5341
Country	:	US
Telephone Number	:	865-922-7443
Fax Number	:	865-922-1604

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/08/2007

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