Provider Demographics
NPI:1982630091
Name:DUKE, SHARON N (DO)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:N
Last Name:DUKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-1023
Mailing Address - Country:US
Mailing Address - Phone:423-839-1200
Mailing Address - Fax:423-839-1250
Practice Address - Street 1:4845 W ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-1023
Practice Address - Country:US
Practice Address - Phone:423-839-1200
Practice Address - Fax:423-839-1250
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2016-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1492207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4260656OtherBCBST
TN3370042Medicare PIN
TX139972723Medicaid
TN3370042Medicaid
TXB22391Medicare UPIN