Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 11716 | MS |
NPI | 1003893652 |
---|---|
Provider Name | Dr. Frederick T Duggan |
First Address | Meridian, MS 39301-3223 |
Second Address | Meridian, MS 39301-3223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2005 |
Last Update Date | 02/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00014341 | (05) | MS |
E34814 | (02) | MS |