Individual
DR. JAMES L DUCKLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT 1233
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118062
BLUE CROSS BLUE SHIELD
TN
05
—
3597450
—
TN
01
—
621429478
PRIVATE HEALTH CARE SYSTE
TN
Enumeration date
06/05/2006
Last updated
09/22/2009
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