Provider Demographics
NPI:1235765108
Name:DUNCAN, TIMOTHY LINCK
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LINCK
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 300 N
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:UT
Mailing Address - Zip Code:84066-2351
Mailing Address - Country:US
Mailing Address - Phone:435-725-7448
Mailing Address - Fax:435-722-9291
Practice Address - Street 1:405 N 500 W
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-1907
Practice Address - Country:US
Practice Address - Phone:435-789-4691
Practice Address - Fax:435-722-9291
Is Sole Proprietor?:No
Enumeration Date:2020-03-22
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
UT13194362-1205207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program