Provider Demographics
NPI:1265417182
Name:DUNCKLEE, GEOFFREY (PHD, CRNA)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:
Last Name:DUNCKLEE
Suffix:
Gender:
Credentials:PHD, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 LLEWELLYN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT GEORGE G MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755-7081
Mailing Address - Country:US
Mailing Address - Phone:301-677-8800
Mailing Address - Fax:
Practice Address - Street 1:1060 GAFFNEY RD
Practice Address - Street 2:BASSETT ARMY COMMUNITY HOSPITAL
Practice Address - City:FT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-5001
Practice Address - Country:US
Practice Address - Phone:907-353-5418
Practice Address - Fax:907-353-4845
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR146328163W00000X, 367500000X
AK25231163W00000X
GARN202515367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse