Provider Demographics
NPI:1518205822
Name:DUKES, CHASE A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:A
Last Name:DUKES
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 1:1219 GUSDORF RD
Mailing Address - Street 2:STE A
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6499
Mailing Address - Country:US
Mailing Address - Phone:575-758-0009
Mailing Address - Fax:575-758-8656
Practice Address - Street 1:210 E DERENNE AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6736
Practice Address - Country:US
Practice Address - Phone:912-644-5300
Practice Address - Fax:912-644-5241
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA081167207X00000X
NMMD2022-0003207X00000X
WAMD60913021207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2030858Medicaid