Provider Demographics
NPI:1932102811
Name:DUCKRO, JOANNE (DPM)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DUCKRO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 E RAHN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5948
Mailing Address - Country:US
Mailing Address - Phone:937-436-3444
Mailing Address - Fax:
Practice Address - Street 1:479 E RAHN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-5948
Practice Address - Country:US
Practice Address - Phone:937-436-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002984213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2012664Medicaid
OH480025938OtherRAILROAD MEDICARE
OH2012664Medicaid