Provider Demographics
NPI:1346281912
Name:DUKES, WILLIAM JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:DUKES
Suffix:JR
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 1:386 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-1432
Mailing Address - Country:US
Mailing Address - Phone:864-654-2067
Mailing Address - Fax:864-654-3261
Practice Address - Street 1:386 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631
Practice Address - Country:US
Practice Address - Phone:864-654-2067
Practice Address - Fax:864-654-3261
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10283207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC080186317OtherRR MEDICARE
SC102837Medicaid
0104890OtherMEDCOST
SC102837Medicaid
SC6315Medicare PIN