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General NPI Number Information
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NPI Number | 1003151424
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Entity Type | Organization
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Legal Business Name | DUNCAN RHEUMATOLOGY CENTER, PLLC
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 05/31/2016
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Provider Practice Location Address
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Address Line | 1509 BROOKWOOD AVE STE B
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City | DUNCAN
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State | OK
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Zip | 73533-1315
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Country | US
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Telephone | 580-786-4590
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Fax | 580-786-4593
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Provider Business Mailing Address
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Address Line | 1509 BROOKWOOD AVE STE B
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City | DUNCAN
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State | OK
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Zip | 73533-1315
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Country | US
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Telephone | 580-786-4590
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Fax | 580-786-4593
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | AMY SHULTZ
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Credential | M.D.
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Telephone | 405-623-3307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 22384
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License Number State | OK
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