Provider Demographics
NPI:1235140120
Name:DUNCAN, KRISTEN TAYLOR (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:TAYLOR
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 POPLAR AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4831
Mailing Address - Country:US
Mailing Address - Phone:901-692-5780
Mailing Address - Fax:901-692-5789
Practice Address - Street 1:6363 POPLAR AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4831
Practice Address - Country:US
Practice Address - Phone:901-692-5780
Practice Address - Fax:901-692-5789
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN0000041096207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI66377Medicare UPIN