Provider Demographics
NPI:1568537199
Name:REGAN, DUNCAN C (DC)
Entity Type:Individual
Prefix:DR
First Name:DUNCAN
Middle Name:C
Last Name:REGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E GENERAL STEWART WAY
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-2610
Mailing Address - Country:US
Mailing Address - Phone:912-876-3964
Mailing Address - Fax:912-876-3965
Practice Address - Street 1:200 E GENERAL STEWART WAY
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2610
Practice Address - Country:US
Practice Address - Phone:912-876-3964
Practice Address - Fax:912-876-3965
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1681111N00000X
NC1214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU22545Medicare UPIN