Provider Demographics
NPI:1558430306
Name:DUKE, KEVIN ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALAN
Last Name:DUKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19465 DEERFIELD AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8446
Mailing Address - Country:US
Mailing Address - Phone:703-723-4333
Mailing Address - Fax:703-723-4343
Practice Address - Street 1:19465 DEERFIELD AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8446
Practice Address - Country:US
Practice Address - Phone:703-723-4333
Practice Address - Fax:703-723-4343
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541954623OtherGREAT WEST POS PPO ACC
541954623OtherNCPPO
VA265563OtherANTHEM POS, PPO
VA1005511OtherASHN AETNA HMO
VA541954623OtherPHCS GUARDIAN
VA629474OtherUNITED HEALTHCARE
F452-0001OtherCAREFIRST
1682306OtherCIGNA PPO
VA541954623OtherUNI CARE
VA7899141OtherAETNA PPO
VA541954623OtherGREAT WEST POS PPO ACC