Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4235 | AK |
N | 207XS0117X | Orthopaedic Spine Surgeon | 4235 | AK |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 4235 | AK |
NPI | 1629132022 |
---|---|
Provider Name | Dr. John T Duddy |
First Address | Anchorage, AK 99508-2972 |
Second Address | Anchorage, AK 99508-2972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87079 | (02) | AK |
MD1419 | (05) | AK |