Provider Demographics
NPI:1417152604
Name:BILL L DUKE II MD PC
Entity Type:Organization
Organization Name:BILL L DUKE II MD PC
Other - Org Name:WOMEN'S HEALTH AND MATERNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:615-792-3214
Mailing Address - Street 1:102 BOYD ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1601
Mailing Address - Country:US
Mailing Address - Phone:615-792-3214
Mailing Address - Fax:615-792-4570
Practice Address - Street 1:102 BOYD ST
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1601
Practice Address - Country:US
Practice Address - Phone:615-792-3214
Practice Address - Fax:615-792-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD35803207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3878282Medicaid
TN=========OtherTAX ID NUMBER
TNC68432Medicare UPIN
3723490Medicare ID - Type UnspecifiedGROUP ID NUMBER