Healthcare Provider Details

I. General information

NPI: 1588650329
Provider Name (Legal Business Name): PATRICK A DUFFY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 JOHN R JUNKIN DR
NATCHEZ MS
39120-3825
US

IV. Provider business mailing address

453 JOHN R JUNKIN DR
NATCHEZ MS
39120-3825
US

V. Phone/Fax

Practice location:
  • Phone: 601-445-2164
  • Fax: 601-446-8185
Mailing address:
  • Phone: 601-445-2164
  • Fax: 601-446-8185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number07891
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: