Provider Demographics
NPI:1851728729
Name:DUNCAN MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:DUNCAN MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERNDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-252-6080
Mailing Address - Street 1:2515 W ELK AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1571
Mailing Address - Country:US
Mailing Address - Phone:580-252-6080
Mailing Address - Fax:580-255-1064
Practice Address - Street 1:2515 W ELK AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1571
Practice Address - Country:US
Practice Address - Phone:580-252-6080
Practice Address - Fax:580-255-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK92834302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization