=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053130237
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HUNTER LEIGH DUNCAN PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2024
-----------------------------------------------------
Last Update Date | 10/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2008 W GRANT AVE
-----------------------------------------------------
City | PAULS VALLEY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73075-9230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-238-7525
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4105 24TH AVE SE APT 10
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73071-0831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-264-5804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 20700
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------