Provider Demographics
NPI:1689749590
Name:DUNCAN, TERRY P (OD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:P
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 WOODS CRESENT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123
Mailing Address - Country:US
Mailing Address - Phone:614-875-8403
Mailing Address - Fax:
Practice Address - Street 1:6682 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4943
Practice Address - Country:US
Practice Address - Phone:614-889-4843
Practice Address - Fax:614-718-9380
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3067152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0283778Medicaid
OHT47357Medicare UPIN
OH0283778Medicaid