Provider Demographics
NPI:1508862152
Name:DUFFEY, JAMES PAUL (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:DUFFEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 KENNERLY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4379
Mailing Address - Country:US
Mailing Address - Phone:904-619-3048
Mailing Address - Fax:
Practice Address - Street 1:6100 KENNERLY RD STE 202
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4379
Practice Address - Country:US
Practice Address - Phone:904-619-3048
Practice Address - Fax:719-562-6255
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME166721207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01343490Medicaid
CO01343490Medicaid