Provider Demographics
NPI:1952651754
Name:DUNCAN, JACOB DOUGLAS (PA-C)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:DOUGLAS
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:245 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-4990
Mailing Address - Country:US
Mailing Address - Phone:817-875-1797
Mailing Address - Fax:
Practice Address - Street 1:7510 N BEACH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-1505
Practice Address - Country:US
Practice Address - Phone:817-498-1818
Practice Address - Fax:817-581-3761
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2017-06-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant