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General NPI Number Information
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NPI Number | 1487720942
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Entity Type | Individual
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Provider Name | CASEY ELLIS DUNCAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 905 MEDICAL PARK DR DEPARTMENT OF RADIATION ONCOLOGY
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City | EFFINGHAM
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State | IL
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Zip | 62401-2190
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Country | US
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Telephone | 217-342-2066
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Fax | 217-342-2074
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Provider Business Mailing Address
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Address Line | 905 MEDICAL PARK DR DEPARTMENT OF RADIATION ONCOLOGY
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City | EFFINGHAM
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State | IL
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Zip | 62401-2190
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Country | US
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Telephone | 217-342-2066
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Fax | 217-342-2074
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 036137340
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License Number State | IL
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