Provider Demographics
NPI:1508036864
Name:DUNCAN, KIRK A
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:A
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 1:1526 SAM HOUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4533
Mailing Address - Country:US
Mailing Address - Phone:936-295-7104
Mailing Address - Fax:
Practice Address - Street 1:1526 SAM HOUSTON AVE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4533
Practice Address - Country:US
Practice Address - Phone:936-295-7104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0043769332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530715OtherBLUE CROSS BLUE SHIELD TX
TX530715OtherBLUE CROSS BLUE SHIELD TX