Provider Demographics
NPI:1386082790
Name:DUNCAN, THOMAS A (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
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 1:1050 REID PARKWAY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1160
Mailing Address - Country:US
Mailing Address - Phone:765-962-9541
Mailing Address - Fax:765-983-3219
Practice Address - Street 1:1050 REID PKWY STE 220
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1160
Practice Address - Country:US
Practice Address - Phone:765-962-9541
Practice Address - Fax:765-966-5952
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020659207V00000X
IN02005155A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGMedicaid
INPENDINGMedicaid
PENDINGOtherANTHEM