Provider Demographics
NPI:1407937451
Name:DUFFIELD, HEIDI HUDSPETH (MS PT)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:HUDSPETH
Last Name:DUFFIELD
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MARIE
Other - Last Name:DUFFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS PT
Mailing Address - Street 1:PO BOX 288
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:AR
Mailing Address - Zip Code:72042-0288
Mailing Address - Country:US
Mailing Address - Phone:870-946-5659
Mailing Address - Fax:
Practice Address - Street 1:317 W 7TH ST
Practice Address - Street 2:GRAND PRAIRIE PHYSICAL THERAPY, INC
Practice Address - City:DE WITT
Practice Address - State:AR
Practice Address - Zip Code:72042-3279
Practice Address - Country:US
Practice Address - Phone:870-946-8400
Practice Address - Fax:870-946-8511
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist