Duncan, Kelly Michael

Duncan, Kelly Michael is an individual health care provider with primary practice located at 1000A Vann Dr , Jackson TN 38305-6001. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Duncan, Kelly Michael can be contacted via phone (731) 668-3018.

Contact Information

Primary practice address
1000A Vann Dr Jackson TN 38305-6001
Phone: (731) 668-3018
Fax: (731) 668-9158
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OD1592 Tennessee

Profile Details

NPI number 1912954983
LBN Legal business name Duncan, Kelly Michael
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated May 21st, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912954983 NPPES
Tennessee Other 4105782 BLUE CROSS BLUE SHEILD
Tennessee Other 5466560004 BLUE CROSS BLUE SHEILD
Tennessee Other 4239243 BLUE CROSS BLUE SHEILD
Tennessee MEDICAID 3943183 BLUE CROSS BLUE SHEILD
Tennessee Other 6414 BLUE CROSS BLUE SHEILD

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