Provider Demographics
NPI:1659434413
Name:DUKES, WILLIAM M (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:M
Last Name:DUKES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73A MEIGS DR
Mailing Address - Street 2:
Mailing Address - City:SHALIMAR
Mailing Address - State:FL
Mailing Address - Zip Code:32579-2145
Mailing Address - Country:US
Mailing Address - Phone:850-651-7020
Mailing Address - Fax:850-651-7020
Practice Address - Street 1:307 BOATNER RD
Practice Address - Street 2:SUITE 115
Practice Address - City:EGLIN AFB
Practice Address - State:FL
Practice Address - Zip Code:32542-1391
Practice Address - Country:US
Practice Address - Phone:850-883-8075
Practice Address - Fax:850-883-8075
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS11990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist