Provider Demographics
NPI:1689971780
Name:DUNCAN, ABRAHAM JACOB (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:JACOB
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3672 JOT EM DOWN RD
Mailing Address - Street 2:
Mailing Address - City:DANIELSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30633-1908
Mailing Address - Country:US
Mailing Address - Phone:706-980-5165
Mailing Address - Fax:
Practice Address - Street 1:355 HIGHWAY 441 S
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-5454
Practice Address - Country:US
Practice Address - Phone:706-212-0581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13104183500000X
GARPH025609183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist