Individual
DR. RENE CHARLES DUFFOURC III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 PARK DR, SUITE C, HOLIDAY ISLAND, AR 72631-9216
(479) 363-9174
(479) 363-9175
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E-6696
AR
2084P0804X
Child & Adolescent Psychiatry Physician
E-6696
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185967001
—
AR
01
—
431560263
TRICARE
AR
Enumeration date
05/01/2007
Last updated
03/12/2013
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