Provider Demographics
NPI:1356527634
Name:DOUGLAS E DUNCAN MD
Entity type:Organization
Organization Name:DOUGLAS E DUNCAN MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-935-1151
Mailing Address - Street 1:304 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-5210
Mailing Address - Country:US
Mailing Address - Phone:903-935-1151
Mailing Address - Fax:903-935-0077
Practice Address - Street 1:304 UNIVERSITY AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-5210
Practice Address - Country:US
Practice Address - Phone:903-935-1151
Practice Address - Fax:903-935-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8760207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP0000GE179Medicaid
TX00W177Medicare PIN
TXB87587Medicare UPIN