Provider Demographics
NPI:1477654838
Name:AUSTIN, DUANE F (MD)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:F
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DUANE
Other - Middle Name:F
Other - Last Name:AUSTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:639 PARK RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3443
Mailing Address - Country:US
Mailing Address - Phone:860-521-9230
Mailing Address - Fax:860-521-1709
Practice Address - Street 1:639 PARK RD
Practice Address - Street 2:SUITE #100
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-3443
Practice Address - Country:US
Practice Address - Phone:860-521-9230
Practice Address - Fax:860-521-1709
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029018207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT180000345OtherPTAN
CT1290189Medicaid
CTB38301Medicare UPIN