Provider Demographics
NPI:1518418268
Name:PHYSICIANS EXPRESS CARE AT DULUTH, LLC
Entity Type:Organization
Organization Name:PHYSICIANS EXPRESS CARE AT DULUTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-772-1830
Mailing Address - Street 1:1780 PEACHTREE PKWY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6834
Mailing Address - Country:US
Mailing Address - Phone:770-772-1830
Mailing Address - Fax:
Practice Address - Street 1:2730 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8626
Practice Address - Country:US
Practice Address - Phone:770-772-1830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care