Healthcare Provider Details

I. General information

NPI: 1184695348
Provider Name (Legal Business Name): KRISTINA ELAINE DUFFY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 FILLINGIM ST USA MEDICAL CENTER
MOBILE AL
36617-2238
US

IV. Provider business mailing address

11699 ARLINGTON BLVD
SPANISH FORT AL
36527
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7117
  • Fax:
Mailing address:
  • Phone: 313-671-6871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD-53717
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number010237316
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD444147
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: