Basic Information
Provider Information
NPI: 1427018589
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNCAN
FirstName: VERNITA
MiddleName: GRAY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 360 E EH CRUMP BLVD
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381265310
CountryCode: US
TelephoneNumber: 9012612000
FaxNumber: 9019469262
Practice Location
Address1: 360 E EH CRUMP BLVD
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381265310
CountryCode: US
TelephoneNumber: 9012612000
FaxNumber: 9019469262
Other Information
ProviderEnumerationDate: 03/24/2006
LastUpdateDate: 06/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD13959TNY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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