Provider Demographics
NPI:1245569102
Name:DUNCAN, EDDIE LOUIS
Entity Type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:LOUIS
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 PINE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4708
Mailing Address - Country:US
Mailing Address - Phone:530-368-4843
Mailing Address - Fax:
Practice Address - Street 1:212 PINE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4708
Practice Address - Country:US
Practice Address - Phone:530-368-4843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)