Provider Demographics
NPI:1972119840
Name:DUNCAN, SAMUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11121 COON HUNTERS RD
Mailing Address - Street 2:
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-9559
Mailing Address - Country:US
Mailing Address - Phone:563-320-0428
Mailing Address - Fax:
Practice Address - Street 1:13609 110TH AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-9033
Practice Address - Country:US
Practice Address - Phone:563-381-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA105356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor