Provider Demographics
NPI:1447980271
Name:DUCKETT, FLOYD E JR (CPC INTERN)
Entity type:Individual
Prefix:MR
First Name:FLOYD
Middle Name:E
Last Name:DUCKETT
Suffix:JR
Gender:M
Credentials:CPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 SPRING MOUNTAIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4102
Mailing Address - Country:US
Mailing Address - Phone:725-735-2700
Mailing Address - Fax:
Practice Address - Street 1:8670 SPRING MOUNTAIN RD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4102
Practice Address - Country:US
Practice Address - Phone:725-735-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional