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General NPI Number Information
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NPI Number | 1437142619
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Entity Type | Individual
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Provider Name | TRACY DIANNE DUNCAN D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 511 N 6TH ST
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-2407
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Country | US
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Telephone | 870-763-2326
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Fax | 870-763-2646
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Provider Business Mailing Address
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Address Line | 511 N 6TH ST
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-2407
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Country | US
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Telephone | 870-763-2326
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Fax | 870-763-2646
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 142
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License Number State | AR
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