Provider Demographics
NPI:1316915168
Name:DUCKWORTH, GARRETT WAYNE JR (MD)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:WAYNE
Last Name:DUCKWORTH
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PUGET SOUND NAVAL SHIPYARD BRANCH HEALTH CLINIC
Mailing Address - Street 2:1400 FARRAGUT AVE, BLDG 940
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98314-0001
Mailing Address - Country:US
Mailing Address - Phone:360-476-6873
Mailing Address - Fax:360-476-2480
Practice Address - Street 1:PUGET SOUND NAVAL SHIPYARD BRANCH HEALTH CLINIC
Practice Address - Street 2:1400 FARRAGUT AVE, BLDG 940
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98314-0001
Practice Address - Country:US
Practice Address - Phone:360-476-6873
Practice Address - Fax:360-476-2480
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2009-11-23
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Provider Licenses
StateLicense IDTaxonomies
WAMD00041802207Q00000X, 2083A0100X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine