Jacob L Duke
Individual provider Active NPI Pharmacist · Parsons, TN
NPI 1831462787 · NPPES record last updated Feb 22, 2012
Key facts
- NPI
- 1831462787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 35801 (TN)
- Practice address
- 179 Tennessee Ave N
Parsons, TN 38363-2002 - Phone
- (731) 847-3784
- Fax
- (731) 847-6167
- NPI assigned
- Feb 22, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35801 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 35801 | TN | Yes |
Addresses
Primary practice location
179 Tennessee Ave N
Parsons, TN 38363-2002
Mailing address
274 Riverview Dr N
Decaturville, TN 38329-5353
Phone (731) 852-2036
Other providers in Parsons, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.