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NPI Code Detail

MEDICARE: RUSSELL CHARLES DUQUETTE MD

MEDICARE: RUSSELL CHARLES DUQUETTE MD
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
1207L00000XAnesthesiology Physician13444AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538139258
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUSSELL CHARLES DUQUETTE MD
Provider Business Mailing Address
First Line : 2901 NORTH CENTRAL AVE
Second Line : STE 500
City : PHOENIX
State : AZ
Zip : 85012-2738
Country : US
Telephone Number : 602-744-4765
Fax Number : 602-744-4799
Provider Business Practice Location Address
First Line : 2901 NORTH CENTRAL AVE
Second Line : STE 500
City : PHOENIX
State : AZ
Zip : 85012-2738
Country : US
Telephone Number : 602-262-8900
Fax Number : 602-262-8919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 07/08/2007

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Directions to “ RUSSELL CHARLES DUQUETTE MD” Practice Location

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