Provider Demographics
NPI:1720020795
Name:DUNCAN, ELBERT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELBERT
Middle Name:ALAN
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:990 SOUTH MADISON STREET
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6308
Practice Address - Country:US
Practice Address - Phone:662-620-7101
Practice Address - Fax:662-842-1457
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS116162085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00017748Medicaid
AL144586Medicaid
AL144351Medicaid
AL144391Medicaid
AL511-30495OtherBLUE CROSS
AL009700300Medicaid
300001093OtherMEDICARE
MS300125168OtherRAILROAD MEDICARE
AL511-30494OtherBLUE CROSS
AL511-55489OtherBLUE CROSS
AL166717Medicaid
AL511-30486OtherBLUE CROSS
MS300125168OtherRAILROAD MEDICARE
AL144586Medicaid
MSB30987Medicare UPIN
MS00017748Medicaid