Provider Demographics
NPI:1497861173
Name:DUNCAN OPTICIANS, INC.
Entity Type:Organization
Organization Name:DUNCAN OPTICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC./TREAS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-255-1172
Mailing Address - Street 1:1619 W ELK AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1725
Mailing Address - Country:US
Mailing Address - Phone:580-255-1172
Mailing Address - Fax:580-255-1234
Practice Address - Street 1:1619 W ELK AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1725
Practice Address - Country:US
Practice Address - Phone:580-255-1172
Practice Address - Fax:580-255-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100768970AMedicaid
OK0689720001Medicare ID - Type Unspecified
OK100768970AMedicaid