Provider Demographics
NPI:1710974647
Name:BIRKY, DUANE LEWIS (MD)
Entity Type:Individual
Prefix:MR
First Name:DUANE
Middle Name:LEWIS
Last Name:BIRKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:24 MAISONS DRIVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9017
Mailing Address - Country:US
Mailing Address - Phone:479-883-7079
Mailing Address - Fax:501-448-2021
Practice Address - Street 1:24 MAISONS DRIVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-9017
Practice Address - Country:US
Practice Address - Phone:479-883-7079
Practice Address - Fax:501-448-2021
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE22332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100047860AMedicaid
AR137776001Medicaid
AR137776001Medicaid
OK100047860AMedicaid