| Organization Name: | DUKE CITY SURGICAL ASSISTING LLC |
| NPI Number: | 1295191351 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REGINA K GANTT (PRESIDENT) |
| Mailing Address: | 28 Valle Lindo Rd Peralta |
| State: | NM US |
| Postal Code: | 870428230 |
| Phone Number: | 5052805326 |
| Fax Number: | |
| NPI Enumeration Date: | 01/05/2016 |
| NPI Last Update Date: | 01/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |