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Individual

MR. MARK EDWIN DUNCAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC, ACNP-BC

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 576-2501
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 576-2501

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
R866350
MS
363LF0000X
Family Nurse Practitioner
Primary
R866350
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01053866
MS
05
138263
AL
01
P01454794
RAILROAD MEDICARE PTAN
MS
Enumeration date
02/05/2009
Last updated
06/18/2015
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