Provider Demographics
NPI:1326546946
Name:DUNCAN, WILLIAM BLANC JR
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BLANC
Last Name:DUNCAN
Suffix:JR
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 1:2055 BERMUDA ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-3801
Mailing Address - Country:US
Mailing Address - Phone:318-218-4595
Mailing Address - Fax:
Practice Address - Street 1:7591 FERN AVE STE 1502
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5748
Practice Address - Country:US
Practice Address - Phone:318-220-8753
Practice Address - Fax:318-220-8764
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor