Provider Demographics
NPI:1366571663
Name:DUFFY, CAROL IBACH (DO)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:IBACH
Last Name:DUFFY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1988 EAST RD
Mailing Address - Street 2:
Mailing Address - City:SHAFTSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05262-9778
Mailing Address - Country:US
Mailing Address - Phone:484-624-2771
Mailing Address - Fax:
Practice Address - Street 1:1988 EAST RD
Practice Address - Street 2:
Practice Address - City:SHAFTSBURY
Practice Address - State:VT
Practice Address - Zip Code:05262-9778
Practice Address - Country:US
Practice Address - Phone:484-624-2771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010240L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease