Provider Demographics
NPI:1255480885
Name:DUNCAN, JEFFREY A (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
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 1:1200 E PECAN ST
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-6141
Mailing Address - Country:US
Mailing Address - Phone:580-379-5000
Mailing Address - Fax:580-379-5509
Practice Address - Street 1:304 S PARK LN
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-5753
Practice Address - Country:US
Practice Address - Phone:580-379-6500
Practice Address - Fax:580-379-6509
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006015216207X00000X
OK4729207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200251880AMedicaid
MO2006015216OtherMISSOURI DO LICENSE
OK4729OtherOKLAHOMA DO LICENSE
OK200251880AMedicaid