Provider Demographics
NPI:1487653028
Name:DUKE, STEVEN IRA (DPH)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:IRA
Last Name:DUKE
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S GAY ST
Mailing Address - Street 2:SUITE 705
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902-1095
Mailing Address - Country:US
Mailing Address - Phone:865-382-9876
Mailing Address - Fax:865-922-1604
Practice Address - Street 1:6909 MAYNARDVILLE PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-5341
Practice Address - Country:US
Practice Address - Phone:865-922-7443
Practice Address - Fax:865-922-1604
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist