Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 27602 | OK |
N | 208200000X | Surgeon | 27602 | OK |
N | 208600000X | Surgeon | 27602 | OK |
NPI | 1548368111 |
---|---|
Provider Name | John P Duffy |
First Address | Oklahoma City, OK 73112-5556 |
Second Address | Oklahoma City, OK 73112-4418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A762050 | PPIN # (01) | CA |
I61575 | (02) | CA |