Provider Demographics
NPI:1093927790
Name:DUNCAN CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:DUNCAN CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:704-987-5050
Mailing Address - Street 1:19824 W CATAWBA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4046
Mailing Address - Country:US
Mailing Address - Phone:704-987-5050
Mailing Address - Fax:704-987-5067
Practice Address - Street 1:19824 W CATAWBA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4046
Practice Address - Country:US
Practice Address - Phone:704-987-5050
Practice Address - Fax:704-987-5067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890834FMedicaid
NC0834FOtherBCBS ID FOR TOM DUNCAN
NC2575OtherSTATE ID TOM DUNCAN D.C.
NC0834FOtherBCBS ID FOR TOM DUNCAN
NC1902918014Medicare UPIN