Provider Demographics
NPI:1902918014
Name:DUNCAN, THOMAS RAYMOND II (DC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:RAYMOND
Last Name:DUNCAN
Suffix:II
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19824 W CATAWBA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4046
Mailing Address - Country:US
Mailing Address - Phone:704-987-5050
Mailing Address - Fax:704-987-5067
Practice Address - Street 1:19824 W CATAWBA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4046
Practice Address - Country:US
Practice Address - Phone:704-987-5050
Practice Address - Fax:704-987-5067
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0834FOtherBLUE CROSS/BLUE SHIELD NC
NC89-0834 FMedicaid
NC2454105Medicare ID - Type Unspecified