Provider Demographics
NPI:1104345271
Name:DENNIS H. DUCK
Entity type:Organization
Organization Name:DENNIS H. DUCK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:DUCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACP
Authorized Official - Phone:865-828-5607
Mailing Address - Street 1:8731 RUTLEDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37861-3112
Mailing Address - Country:US
Mailing Address - Phone:865-828-5595
Mailing Address - Fax:865-828-5607
Practice Address - Street 1:8731 RUTLEDGE PIKE
Practice Address - Street 2:
Practice Address - City:RUTLEDGE
Practice Address - State:TN
Practice Address - Zip Code:37861-3112
Practice Address - Country:US
Practice Address - Phone:865-828-5595
Practice Address - Fax:865-828-5607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty