Provider Demographics
NPI:1164858437
Name:DUNCAN, MARY GRICE (PHARM D)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:GRICE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 769
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:AR
Mailing Address - Zip Code:72556-0769
Mailing Address - Country:US
Mailing Address - Phone:870-368-3100
Mailing Address - Fax:870-368-3134
Practice Address - Street 1:600 N. MAIN STREET
Practice Address - Street 2:SUITE C
Practice Address - City:MELBOURNE
Practice Address - State:AR
Practice Address - Zip Code:72556
Practice Address - Country:US
Practice Address - Phone:870-368-3100
Practice Address - Fax:870-368-3134
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR-08360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist