Basic Information
Provider Information
NPI: 1588602346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNCAN
FirstName: JAMES
MiddleName: LEVI
NamePrefix:  
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 INDEPENDENCE PT
Address2: SUITE 212
City: GREENVILLE
State: SC
PostalCode: 296154545
CountryCode: US
TelephoneNumber: 8647976044
FaxNumber:  
Practice Location
Address1: 1210 W FARIS RD
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296054444
CountryCode: US
TelephoneNumber: 8642954410
FaxNumber: 8642955694
Other Information
ProviderEnumerationDate: 06/03/2006
LastUpdateDate: 08/02/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X7258SCY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
P0081359401SCRAILROAD MEDICAREOTHER
07258405SC MEDICAID


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