Provider Demographics
NPI:1427079334
Name:DUFFIELD, DEBORAH S (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:DUFFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 DESALES AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1161
Mailing Address - Country:US
Mailing Address - Phone:423-495-2620
Mailing Address - Fax:423-495-2625
Practice Address - Street 1:2525 DESALES AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1161
Practice Address - Country:US
Practice Address - Phone:423-495-2620
Practice Address - Fax:423-495-2625
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD25775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00300021OtherRR MEDICARE
TN3095727Medicaid
GA000900897BMedicaid
TNP00300021OtherRR MEDICARE
TNG18080Medicare UPIN
TN3095727Medicaid