Provider Demographics
NPI:1497973184
Name:WILLIAM P. DUFFY, M.D., INC.
Entity Type:Organization
Organization Name:WILLIAM P. DUFFY, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-452-6601
Mailing Address - Street 1:1767 TRIBUTE RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4409
Mailing Address - Country:US
Mailing Address - Phone:916-564-6601
Mailing Address - Fax:916-564-6603
Practice Address - Street 1:1767 TRIBUTE RD
Practice Address - Street 2:SUITE H
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4409
Practice Address - Country:US
Practice Address - Phone:916-564-6601
Practice Address - Fax:916-564-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC321550207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA200033283OtherRAILROAD MEDICARE
CAA34496Medicare UPIN
CAZZZ06516ZMedicare PIN