Provider Demographics
NPI:1629165360
Name:DUKE UNIVERSITY
Entity Type:Organization
Organization Name:DUKE UNIVERSITY
Other - Org Name:DUKE UNIVERSITY ANAPLASTOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE DEAN ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-684-3945
Mailing Address - Street 1:PO BOX 110566
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709-5566
Mailing Address - Country:US
Mailing Address - Phone:919-620-4855
Mailing Address - Fax:
Practice Address - Street 1:1000 TRENT DR
Practice Address - Street 2:DUKE SOUTH, ROOM 175
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-5228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0890200004OtherDME NUMBER