Provider Demographics
NPI:1730628603
Name:DUKES, SETH ALLEN (PA-C)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:ALLEN
Last Name:DUKES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 LONDONTOWN WAY APT 1179
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2712
Mailing Address - Country:US
Mailing Address - Phone:865-306-0769
Mailing Address - Fax:
Practice Address - Street 1:816 LONDONTOWN WAY APT 1179
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2712
Practice Address - Country:US
Practice Address - Phone:865-306-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3238363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant