Provider Demographics
NPI:1982971149
Name:DUNCAN, TOMMY D (RPH)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:D
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-1443
Mailing Address - Country:US
Mailing Address - Phone:816-233-7830
Mailing Address - Fax:
Practice Address - Street 1:3645 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3033
Practice Address - Country:US
Practice Address - Phone:816-232-5342
Practice Address - Fax:816-232-2635
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO041575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist