Individual
DR. KEITH DUFFY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UNIVERSITY OF UTAH DEPT OF, 50 N MEDICAL DR, SALT LAKE CITY, UT 84112-1102
(801) 587-6340
(801) 587-6346
Mailing address
PO BOX 3208, SALT LAKE CITY, UT 84110-3208
(801) 587-6340
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
6099540-1205
UT
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
6099540-1205
UT
207ND0900X
Dermatopathology Physician
60995401205
UT
207NS0135X
Procedural Dermatology Physician
60995401205
UT
Other
Enumeration date
09/19/2007
Last updated
11/05/2021
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