Provider Demographics
NPI:1497811996
Name:DUFFY, STEVEN WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WAYNE
Last Name:DUFFY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 NW 50TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2295
Mailing Address - Country:US
Mailing Address - Phone:405-949-0434
Mailing Address - Fax:405-949-0330
Practice Address - Street 1:4430 NW 50TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2298
Practice Address - Country:US
Practice Address - Phone:405-949-0434
Practice Address - Fax:405-949-0330
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK235431500Medicare ID - Type Unspecified
OKU86465Medicare UPIN