Healthcare Provider Details

I. General information

NPI: 1104096510
Provider Name (Legal Business Name): KNOWLES-DUNCAN & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 LOGAN ST SUITE 120
NOBLESVILLE IN
46060-1557
US

IV. Provider business mailing address

341 LOGAN ST SUITE 120
NOBLESVILLE IN
46060-1557
US

V. Phone/Fax

Practice location:
  • Phone: 317-776-3310
  • Fax:
Mailing address:
  • Phone: 317-776-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRADLEY KEITH DUNCAN
Title or Position: VP
Credential:
Phone: 317-776-3310