Provider Demographics
NPI:1407605868
Name:DUFFNER, GERALD III (HAS 0741)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:
Last Name:DUFFNER
Suffix:III
Gender:M
Credentials:HAS 0741
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 JOHNNIE DODDS BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-1704
Mailing Address - Country:US
Mailing Address - Phone:843-714-8198
Mailing Address - Fax:
Practice Address - Street 1:800 JOHNNIE DODDS BLVD STE 109
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-1704
Practice Address - Country:US
Practice Address - Phone:843-884-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS0741237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist