Provider Demographics
NPI:1326058868
Name:DUKE, RICHARD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:DUKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4527
Mailing Address - Country:US
Mailing Address - Phone:432-582-8000
Mailing Address - Fax:
Practice Address - Street 1:1340 E 7TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4724
Practice Address - Country:US
Practice Address - Phone:432-582-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6593207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111969100OtherSOUTHWEST LIFE & HEALTH
TX83552GOtherBCBS
TX135631307Medicaid
TX181001200OtherDEPT OF LABOR
TX200040258OtherRAILROAD
TX4347743OtherAETNA
TXMDF6593OtherWORKMENS COMPENSATION
TX111969100OtherSOUTHWEST LIFE & HEALTH
TXB87570Medicare UPIN