Provider Demographics
NPI:1316097439
Name:DUNCAN, THOMAS KOBINA (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:KOBINA
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8708
Mailing Address - Country:US
Mailing Address - Phone:678-442-3290
Mailing Address - Fax:678-442-2733
Practice Address - Street 1:1000 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-7694
Practice Address - Country:US
Practice Address - Phone:678-442-3290
Practice Address - Fax:678-442-3282
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA56536208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00294610OtherRAILROAD MEDICARE
GA945791754AMedicaid
GAP00294610OtherRAILROAD MEDICARE
GA945791754AMedicaid