Provider Demographics
NPI:1780473298
Name:DUVAL MEDICAL, P.A.
Entity type:Organization
Organization Name:DUVAL MEDICAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FAUCETT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:859-550-6526
Mailing Address - Street 1:2064 PARK ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3810
Mailing Address - Country:US
Mailing Address - Phone:859-550-6526
Mailing Address - Fax:
Practice Address - Street 1:2064 PARK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-3810
Practice Address - Country:US
Practice Address - Phone:859-550-6526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty