Provider Demographics
NPI:1609803535
Name:JAMES B DUKE MD PA
Entity Type:Organization
Organization Name:JAMES B DUKE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-867-0444
Mailing Address - Street 1:2300 SE 17 STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-9107
Mailing Address - Country:US
Mailing Address - Phone:352-867-0444
Mailing Address - Fax:352-867-5522
Practice Address - Street 1:2300 SE 17TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-9107
Practice Address - Country:US
Practice Address - Phone:352-867-0444
Practice Address - Fax:352-867-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048787174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE85415Medicare UPIN
FLQ0372Medicare PIN
FL11987Medicare ID - Type Unspecified