Individual
KENNETH MARK DUFFY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
809 NE HIGHWAY 60, SEILING, OK 73663
(580) 922-4283
(580) 922-7717
Mailing address
PO BOX 838, SEILING, OK 73663-0838
(580) 922-4283
(580) 922-7717
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12688
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010018239
RAILROAD MEDICARE
—
01
—
0154440001
PALMETTO MEDICARE
—
05
—
100094530A
—
OK
Enumeration date
07/14/2005
Last updated
06/05/2009
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