Provider Demographics
NPI:1841518198
Name:DUGGAN, JESSICA (DPM)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 S 8TH AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7154
Mailing Address - Country:US
Mailing Address - Phone:928-726-9650
Mailing Address - Fax:928-726-1605
Practice Address - Street 1:2741 S 8TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7154
Practice Address - Country:US
Practice Address - Phone:928-726-9650
Practice Address - Fax:928-726-1605
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0763213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery