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General NPI Number Information
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NPI Number | 1063489854
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Entity Type | Individual
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Provider Name | NANCY R. DUNCAN-LARRY PA
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Gender | Female
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 702 W BROADWAY ST
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City | SPIRO
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State | OK
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Zip | 74959-2430
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Country | US
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Telephone | 918-962-2442
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Fax | 918-962-3895
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Provider Business Mailing Address
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Address Line | PO BOX 402319
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City | ATLANTA
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State | GA
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Zip | 30384-2319
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Country | US
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Telephone | 479-709-7399
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Fax | 479-709-7053
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA247
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1299
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License Number State | OK
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