Provider Demographics
NPI:1962025551
Name:DUKES, ANTHONY LAMAR
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LAMAR
Last Name:DUKES
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 1:1076 PEERLESS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3664
Mailing Address - Country:US
Mailing Address - Phone:330-564-3824
Mailing Address - Fax:
Practice Address - Street 1:1076 PEERLESS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3664
Practice Address - Country:US
Practice Address - Phone:330-564-3824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRY177215251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0126962OtherMEDICADE