Healthcare Provider Details

I. General information

NPI: 1407871882
Provider Name (Legal Business Name): GEORGE DUNCAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GEORGE DUNCAN MD

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 E LAKE SHORE DR SUITE 307
DECATUR IL
62521-3832
US

IV. Provider business mailing address

1770 E LAKE SHORE DR SUITE 307
DECATUR IL
62521-3832
US

V. Phone/Fax

Practice location:
  • Phone: 217-428-1500
  • Fax: 217-428-1512
Mailing address:
  • Phone: 217-428-1500
  • Fax: 217-428-1512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036088836
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: