Provider Demographics
NPI:1194767376
Name:DUPLOOY, JOHANNES J (MD)
Entity type:Individual
Prefix:DR
First Name:JOHANNES
Middle Name:J
Last Name:DUPLOOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:605 GLENWOOD DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1108
Mailing Address - Country:US
Mailing Address - Phone:423-495-2690
Mailing Address - Fax:423-495-2698
Practice Address - Street 1:605 GLENWOOD DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1108
Practice Address - Country:US
Practice Address - Phone:423-495-2690
Practice Address - Fax:423-495-2698
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN34783207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA053801146AMedicaid
TN3862844Medicare ID - Type Unspecified