Provider Demographics
NPI:1538155122
Name:DUNCAN, MARK O (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:O
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502
Mailing Address - Country:US
Mailing Address - Phone:580-357-9984
Mailing Address - Fax:580-357-3277
Practice Address - Street 1:110 NW 31ST ST FL 2
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6100
Practice Address - Country:US
Practice Address - Phone:580-248-5255
Practice Address - Fax:580-248-2036
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2013-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3848207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100114100AMedicaid
140007550OtherRAILROAD MEDICARE
OK7358213OtherAETNA
OK175194701OtherDOL
H18286Medicare UPIN