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General NPI Number Information
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NPI Number | 1891712774
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Entity Type | Individual
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Provider Name | CHERYL EATON DUNCAN P.A.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 10/13/2017
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Provider Practice Location Address
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Address Line | 1453 E BERT KOUNS INDUSTRIAL LOOP
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City | SHREVEPORT
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State | LA
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Zip | 71105-6800
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Country | US
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Telephone | 318-681-4138
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Fax | 318-681-4596
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Provider Business Mailing Address
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Address Line | 919 HIDDEN RDG
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City | IRVING
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State | TX
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Zip | 75038-3813
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Country | US
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Telephone | 469-282-2711
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Fax | 469-282-0996
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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 | A10385
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License Number State | LA
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