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NPI Code Detail

MEDICARE: DR. JENIQUA JEFFERSON DUNCAN DO

MEDICARE: DR. JENIQUA JEFFERSON DUNCAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician1094SC

General Provider Information

NPI Number : 1316130800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENIQUA JEFFERSON DUNCAN DO
Provider Business Mailing Address
First Line : PO BOX 1090
Second Line :
City : HARTSVILLE
State : SC
Zip : 29551-1090
Country : US
Telephone Number : 843-857-0111
Fax Number : 843-857-0206
Provider Business Practice Location Address
First Line : 1268 S 4TH ST
Second Line :
City : HARTSVILLE
State : SC
Zip : 29550-0703
Country : US
Telephone Number : 843-332-3422
Fax Number : 843-332-3985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2007
Last Update Date : 07/26/2021

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