Individual
MR. DOUGLAS DUFFY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
520 N MONTE VISTA ST STE C, ADA, OK 74820-4674
(580) 272-0018
(580) 272-0657
Mailing address
100 MCDOUGAL DR, HOLDENVILLE, OK 74848-2822
(580) 272-0018
(580) 272-0657
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
407
OK
363AS0400X
Surgical Physician Assistant
5601002737
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200194390A
—
OK
Enumeration date
10/23/2006
Last updated
08/26/2019
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