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General NPI Number Information
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NPI Number | 1881021905
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Entity Type | Organization
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Legal Business Name | OAK HARBOR PRIMARY CARE PLLC
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 135 SOUTH EAST ELY ST.
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City | OAK HARBOR
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State | WA
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Zip | 98277-9031
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Country | US
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Telephone | 360-682-5444
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Fax | 360-682-5639
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Provider Business Mailing Address
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Address Line | 135 SE ELY ST.
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City | OAK HARBOR
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State | WA
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Zip | 98277-9031
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Country | US
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Telephone | 360-682-5444
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Fax | 360-682-5639
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MARK RICHARD DUNCAN
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Credential | M.D.
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Telephone | 360-929-4936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 201232264714
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License Number State | WA
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