Individual
DR. KELLY MICHAEL DUNCAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O D
Contact information
Practice address
1000A VANN DR, JACKSON, TN 38305-6001
(731) 668-3018
(731) 668-9158
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD1592
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3943183
—
TN
01
—
4105782
BLUE CROSS BLUE SHEILD
TN
01
—
4239243
CIGNA HEALTHCARE
—
01
—
5466560004
MEDICARE DMEPOS
TN
01
—
6414
TLC MEMPHIS MANAGED CARE
TN
Enumeration date
05/27/2006
Last updated
05/21/2024
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