Basic Information
| Provider Information | |||||||||
| NPI: | 1477503449 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUNCAN | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 JOHNSON FERRY RD | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048518000 | ||||||||
| FaxNumber: | 4048516325 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 JOHNSON FERRY RD | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048518000 | ||||||||
| FaxNumber: | 4048516325 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2006 | ||||||||
| LastUpdateDate: | 10/05/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | ME96250 | FL | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 35047778 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 208M00000X | 068505 | GA | N | Allopathic & Osteopathic Physicians | Hospitalist | 2085R0001X | 068505 | GA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 017040400 | 05 | FL | MEDICAID | 344490 | 01 | FL | AVMED | OTHER | 4013434 | 01 | FL | AETNA | OTHER | P971572 | 01 | FL | OPTIMUM | OTHER | 14360 | 01 | FL | DIMENSION HEALTH PPO | OTHER | 4013734 | 01 | FL | AETNA | OTHER | 0535139 | 05 | OH | MEDICAID | 14CV0 | 01 | FL | BCBS | OTHER | P01583812 | 01 | FL | RR MEDICARE | OTHER | P1006953 | 01 | FL | FREEDOM | OTHER | 61432B | 01 | FL | BCBS | OTHER | 559203 | 01 | FL | WELLCARE | OTHER | 8902290 | 01 | FL | CIGNA | OTHER |