Provider Demographics
NPI:1699719864
Name:DUNCAN, CORY (MD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 SPRING ST NE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3715
Mailing Address - Country:US
Mailing Address - Phone:770-867-3400
Mailing Address - Fax:
Practice Address - Street 1:535 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3772
Practice Address - Country:US
Practice Address - Phone:678-923-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1057743A207P00000X
TXN7417207P00000X
GA77610207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217503602Medicaid
TX217503601Medicaid
TXP00911192OtherRRMCARE THRU AEMA
TXP00911192OtherRRMCARE THRU AEMA
INI18838Medicare UPIN
TX217503602Medicaid