Individual
DR. DEANNA FAE DUCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1210 JEFFERSON ST, CARLYLE, IL 62231-1323
(618) 594-2454
(618) 594-2404
Mailing address
1210 JEFFERSON ST, CARLYLE, IL 62231-1323
(618) 594-2454
(618) 594-2404
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0001405329
IL
Other
Enumeration date
09/15/2005
Last updated
07/08/2007
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