Provider Demographics
NPI:1689433153
Name:DUKEMINIER, JAMES ROBERT
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:DUKEMINIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 CRISCOE RD
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:AL
Mailing Address - Zip Code:35175-5104
Mailing Address - Country:US
Mailing Address - Phone:256-843-9095
Mailing Address - Fax:
Practice Address - Street 1:468 CRISCOE RD
Practice Address - Street 2:
Practice Address - City:UNION GROVE
Practice Address - State:AL
Practice Address - Zip Code:35175-5104
Practice Address - Country:US
Practice Address - Phone:256-843-9095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist