Provider Demographics
NPI:1457631905
Name:DUFFY, DAVID P (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:DUFFY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3026
Mailing Address - Country:US
Mailing Address - Phone:608-831-6548
Mailing Address - Fax:608-831-4995
Practice Address - Street 1:2010 BRANCH ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3026
Practice Address - Country:US
Practice Address - Phone:608-831-6548
Practice Address - Fax:608-831-4995
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9383-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist