Provider Demographics
NPI:1518199132
Name:DUNCAN, ROBERT LAIRD III
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LAIRD
Last Name:DUNCAN
Suffix:III
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 1:950 CUMMINGS CTR
Mailing Address - Street 2:SUITE 97 X
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6508
Mailing Address - Country:US
Mailing Address - Phone:617-283-4413
Mailing Address - Fax:
Practice Address - Street 1:950 CUMMINGS CTR
Practice Address - Street 2:SUITE 97 X
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6508
Practice Address - Country:US
Practice Address - Phone:617-283-4413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-15
Last Update Date:2009-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6165156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician