Provider Demographics
NPI:1164459921
Name:DUNCAN, GREGORY JOHN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JOHN
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:WRANGELL
Mailing Address - State:AK
Mailing Address - Zip Code:99929-0392
Mailing Address - Country:US
Mailing Address - Phone:707-951-9203
Mailing Address - Fax:
Practice Address - Street 1:ZIMOVIA HIGHWAY MILE 5.5
Practice Address - Street 2:
Practice Address - City:WRANGELL
Practice Address - State:AK
Practice Address - Zip Code:99929-9992
Practice Address - Country:US
Practice Address - Phone:707-951-9203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44032207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA044032OtherCALIFORNIA MEDICAL LICENSE
CAP00181543OtherRAILROAD MEDICARE
CA00A440320Medicaid
CA00A440320Medicare ID - Type Unspecified
CA00A440320Medicaid