Provider Demographics
NPI:1174623789
Name:DUNCAN, JERRY N (PHD, ABPP)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:N
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 STUBBEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-8661
Mailing Address - Country:US
Mailing Address - Phone:918-740-9588
Mailing Address - Fax:
Practice Address - Street 1:1637 STUBBEMAN AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8661
Practice Address - Country:US
Practice Address - Phone:918-740-9588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK376103TC0700X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical