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Individual

MR. RANDY L MCDUFFY

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
1507 W QUITMAN ST, IUKA, MS 38852-1132
(662) 423-1000
(662) 423-1316
Mailing address
1507 W QUITMAN ST, IUKA, MS 38852-1132
(662) 423-1000
(662) 423-1316

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R803373
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02353870
MS
Enumeration date
06/21/2005
Last updated
07/08/2007
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