Provider Demographics
NPI:1114241197
Name:DUNCAN, HEATHER DAWN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DAWN
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 W GOLDEN ROD
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-4308
Mailing Address - Country:US
Mailing Address - Phone:918-906-8861
Mailing Address - Fax:
Practice Address - Street 1:10131 E 21ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129-1601
Practice Address - Country:US
Practice Address - Phone:918-664-9972
Practice Address - Fax:918-663-3508
Is Sole Proprietor?:No
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist