Provider Demographics
NPI:1750377651
Name:DUNCAN, THOMAS LEE (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-526-1280
Mailing Address - Fax:828-526-1285
Practice Address - Street 1:209 HOSPITAL DR
Practice Address - Street 2:SUITE 303
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741-7616
Practice Address - Country:US
Practice Address - Phone:828-526-4942
Practice Address - Fax:828-526-9218
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23031207Q00000X
NC2013-00914207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1750377651Medicaid
NCNCD510A194OtherMEDICARE PTAN
IAA02230Medicare UPIN