=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568406296
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID K DUNCAN PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2006
-----------------------------------------------------
Last Update Date | 05/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2413 PALMER CIRCLE
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-321-3868
-----------------------------------------------------
Fax | 405-321-5348
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2413 PALMER CIRCLE
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-321-3868
-----------------------------------------------------
Fax | 405-321-5348
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. MARLA DUNCAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 405-321-3868
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number | 17723
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------