Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 25239 | TN |
NPI | 1003871195 |
---|---|
Provider Name | Richard W Duncan |
First Address | Johnson City, TN 37601-1748 |
Second Address | Johnson City, TN 37601-1748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 16/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3081945 | (05) | TN |
F52267 | (02) |