Basic Information
| Provider Information | |||||||||
| NPI: | 1235103763 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNCANSON | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MED, ATC, CSCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 15162 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379015162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659741359 | ||||||||
| FaxNumber: | 8659741259 | ||||||||
| Practice Location | |||||||||
| Address1: | 1704 JOHNNY MAJORS DR | ||||||||
| Address2: | RM. 117A, NEYLAND-THOMPSON SPORTS CENTER | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379964538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659741359 | ||||||||
| FaxNumber: | 8659741259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 03/05/2008 | ||||||||
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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 | 174400000X | AL 1441 | FL | N | Other Service Providers | Specialist | 2255A2300X | 0000001073 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.