MEDICARE: DR. JOHN C DUFF O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	030000175	VT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	410003059	OTHER	VT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629033394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN C DUFF O.D.

Provider Business Mailing Address
First Line	:	399 CANAL ST
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6619
Country	:	US
Telephone Number	:	802-254-6611
Fax Number	:	802-258-4655

Provider Business Practice Location Address
First Line	:	399 CANAL ST
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6619
Country	:	US
Telephone Number	:	802-254-6611
Fax Number	:	802-258-4655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	03/27/2014

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