Provider Demographics
NPI:1033502356
Name:DUTY, PATRICK RYAN
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:RYAN
Last Name:DUTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:WHITMAN
Mailing Address - State:WV
Mailing Address - Zip Code:25652-0009
Mailing Address - Country:US
Mailing Address - Phone:304-687-4273
Mailing Address - Fax:
Practice Address - Street 1:901 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508
Practice Address - Country:US
Practice Address - Phone:304-855-1032
Practice Address - Fax:304-855-8341
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist