Provider Demographics
NPI:1457730749
Name:KNOWLES DUNCAN & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:KNOWLES DUNCAN & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOWLES DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-776-3310
Mailing Address - Street 1:341 LOGAN STREET
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060
Mailing Address - Country:US
Mailing Address - Phone:317-776-3310
Mailing Address - Fax:317-776-3577
Practice Address - Street 1:341 LOGAN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1557
Practice Address - Country:US
Practice Address - Phone:317-776-3310
Practice Address - Fax:317-776-3577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042811A261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN798900JMedicare PIN