Healthcare Provider Details

I. General information

NPI: 1083723944
Provider Name (Legal Business Name): WILLIAM MICHAEL DUFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 HOSPITAL DR
OSAGE BEACH MO
65065-3050
US

IV. Provider business mailing address

PO BOX 1500
OSAGE BEACH MO
65065-1500
US

V. Phone/Fax

Practice location:
  • Phone: 573-302-2990
  • Fax: 573-302-2992
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberR7420
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR7420
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: