MEDICARE: JOHNNY D DUNCAN DO

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	207T00000X	Neurological Surgery Physician	3110	OK
2	2081N0008X	Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician	3110	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	140007299	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	175194701	OTHER	OK	DOL
2	5959599	OTHER	OK	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790771095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNNY D DUNCAN DO

Provider Business Mailing Address
First Line	:	PO BOX 785
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73502
Country	:	US
Telephone Number	:	580-357-9984
Fax Number	:	580-357-3277

Provider Business Practice Location Address
First Line	:	3201 W GORE BLVD STE 201
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-6350
Country	:	US
Telephone Number	:	805-250-6659
Fax Number	:	580-250-5249

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	08/21/2023

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Directions to “ JOHNNY D DUNCAN DO” Practice Location

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