1437239639 NPI number — DUNCAN PEDORTHICS INC

Table of content: (NPI 1437239639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437239639 NPI number — DUNCAN PEDORTHICS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUNCAN PEDORTHICS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437239639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2210-A 9TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHPORT
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35476-4041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-391-2002
Provider Business Mailing Address Fax Number:
205-391-2036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2210-A 9TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHPORT
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35476-4041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-391-2002
Provider Business Practice Location Address Fax Number:
205-391-2036
Provider Enumeration Date:
10/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DUNCAN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
KENT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
205-391-2002

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51500847DUN . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com