Provider Demographics
NPI:1750473039
Name:DUNCAN, DEANNA VIOLA (MD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:VIOLA
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1800 ROSSVILLE AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-1912
Mailing Address - Country:US
Mailing Address - Phone:423-531-6555
Mailing Address - Fax:423-531-6565
Practice Address - Street 1:1800 ROSSVILLE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1912
Practice Address - Country:US
Practice Address - Phone:423-531-6555
Practice Address - Fax:423-531-6565
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN29730207Q00000X
GA322043207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I085803Medicare PIN
3828745Medicare ID - Type Unspecified
245802Medicare PIN
G83536Medicare UPIN