Provider Demographics
NPI:1376667741
Name:DENSLER, DUANE WESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:WESLEY
Last Name:DENSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 AUDUBON PLAZA DR STE 330
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1319
Practice Address - Country:US
Practice Address - Phone:502-583-1697
Practice Address - Fax:502-583-2120
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35812207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00419636OtherRAILROAD MEDICARE
KY7100014070Medicaid
KY3403753Medicare PIN