Provider Demographics
NPI:1174543516
Name:DUFFY, KAREN B (MD)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:B
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 BRIARVILLE ROAD
Mailing Address - Street 2:BUILDING B
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115
Mailing Address - Country:US
Mailing Address - Phone:615-868-9959
Mailing Address - Fax:615-865-1463
Practice Address - Street 1:1210 BRIARVILLE ROAD
Practice Address - Street 2:BLDING B
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115
Practice Address - Country:US
Practice Address - Phone:615-868-9959
Practice Address - Fax:615-865-1463
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000008280208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3185053Medicaid
TN3185053Medicaid
TN3185053Medicare ID - Type Unspecified