MEDICARE: DR. HARELLE CASSY DUNCAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME105010	FL
2	207R00000X	Internal Medicine Physician	062882	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	146J2	OTHER	FL	BC/BC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174718837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARELLE CASSY DUNCAN M.D.

Provider Business Mailing Address
First Line	:	10365 HOOD RD S STE 204
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-3261
Country	:	US
Telephone Number	:	904-326-0181
Fax Number	:	855-538-2401

Provider Business Practice Location Address
First Line	:	10365 HOOD RD S STE 204
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-3261
Country	:	US
Telephone Number	:	904-326-0181
Fax Number	:	855-538-2401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	03/09/2026

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