Provider Demographics
NPI:1144360983
Name:DUNCAN FMLY PRACTICE & ASSOC
Entity type:Organization
Organization Name:DUNCAN FMLY PRACTICE & ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-201-5165
Mailing Address - Street 1:1209 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-0000
Mailing Address - Country:US
Mailing Address - Phone:304-201-5165
Mailing Address - Fax:
Practice Address - Street 1:1209 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-0000
Practice Address - Country:US
Practice Address - Phone:304-201-5165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9338691Medicare PIN
WVG62583Medicare UPIN