Individual
DR. DERRICK R. DUFFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
105 THORNHILL DR, HATTIESBURG, MS 39402-1548
(601) 261-3737
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3737
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
15467
MS
207Q00000X
Family Medicine Physician
Primary
15467
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121060
—
MS
05
—
1030945
—
LA
Enumeration date
12/04/2006
Last updated
08/11/2020
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