Provider Demographics
NPI:1801601430
Name:DUCKWORTH, ANTHONY RONNELL
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:RONNELL
Last Name:DUCKWORTH
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 1:25441 CHATWORTH DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1841
Mailing Address - Country:US
Mailing Address - Phone:216-262-3760
Mailing Address - Fax:
Practice Address - Street 1:25441 CHATWORTH DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1841
Practice Address - Country:US
Practice Address - Phone:216-262-3760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health