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1184690083

NPI Code Detail

MEDICARE: KELLY HERNE DUNCAN MD

MEDICARE: KELLY HERNE DUNCAN MD

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	207N00000X	Dermatology Physician	L2317	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F0819	OTHER		MEDICARE - BRAZORIA
5	P00264644	OTHER		RR MEDICARE - BRAZORIA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8J9633	OTHER		BCBS
3	7921718	OTHER		AETNA PPO
4	3833541	OTHER		AETNA HMO

General Provider Information

NPI Number	:	1184690083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY HERNE DUNCAN MD

Provider Business Mailing Address
First Line	:	801 YORK ST
Second Line	:
City	:	MANITOWOC
State	:	WI
Zip	:	54220-4630
Country	:	US
Telephone Number	:	920-663-9008
Fax Number	:	920-684-1439

Provider Business Practice Location Address
First Line	:	2051 GREENHOUSE RD STE 270
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-7573
Country	:	US
Telephone Number	:	281-665-4444
Fax Number	:	281-392-6766

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	06/25/2025

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Directions to “ KELLY HERNE DUNCAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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