Provider Demographics
NPI:1902868508
Name:DUNCAN, EVA RENEE (PT)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:RENEE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:RENEE
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:256 FORT SANDERS WEST BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3355
Mailing Address - Country:US
Mailing Address - Phone:865-558-4491
Mailing Address - Fax:865-558-4493
Practice Address - Street 1:260 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-558-4491
Practice Address - Fax:865-558-4493
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3659553Medicaid
9161720OtherAETNA
TN4109999OtherBLUE CROSS BLUE SHIELD
TN3311832OtherCIGNA
TN4109999OtherBLUE CROSS BLUE SHIELD