Provider Demographics
NPI:1477726271
Name:DUFFY, PATRICK EDWARD (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:EDWARD
Last Name:DUFFY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:3250 GORDONVILLE RD STE 358
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5095
Practice Address - Country:US
Practice Address - Phone:573-331-3155
Practice Address - Fax:573-331-5096
Is Sole Proprietor?:No
Enumeration Date:2008-04-12
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9261208600000X
SC910322086S0129X
NH345072086S0129X
MO20230202472086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3149044Medicaid
TX8L9872Medicare PIN
TXP00795790Medicare PIN