Provider Demographics
NPI:1659085777
Name:DUKE HEALTH INTEGRATED PRACTICE, INC.
Entity Type:Organization
Organization Name:DUKE HEALTH INTEGRATED PRACTICE, INC.
Other - Org Name:KERNODLE CLINIC MEBANE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-620-4855
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:919-620-4810
Mailing Address - Fax:
Practice Address - Street 1:101 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7639
Practice Address - Country:US
Practice Address - Phone:919-563-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUKE HEALTH INTEGRATED PRACTICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty