Provider Demographics
NPI:1710871660
Name:CUKE, DAVID JR
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CUKE
Suffix:JR
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 1:788 GURLEY PIKE
Mailing Address - Street 2:
Mailing Address - City:GURLEY
Mailing Address - State:AL
Mailing Address - Zip Code:35748-9757
Mailing Address - Country:US
Mailing Address - Phone:256-203-6616
Mailing Address - Fax:
Practice Address - Street 1:100 SPENRYN DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1890
Practice Address - Country:US
Practice Address - Phone:256-772-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL25-429449Other25-429449