Basic Information
Provider Information
NPI: 1649261553
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUFF
FirstName: ARTHUR
MiddleName: DENNING
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11050 MT BELVEDERE BLVD
Address2: ATTN: CREDENTIALS
City: FORT DRUM
State: NY
PostalCode: 136025004
CountryCode: US
TelephoneNumber: 3157724025
FaxNumber:  
Practice Location
Address1: 11050 MOUNT BELVEDERE BLVD
Address2: ATTN: CREDENTIALS
City: FORT DRUM
State: NY
PostalCode: 136025438
CountryCode: US
TelephoneNumber: 3157724025
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/31/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080A0000XC42876CAY Allopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine

No ID Information.


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