Provider Demographics
NPI:1871621037
Name:STEVEN DUFFY, DC
Entity type:Organization
Organization Name:STEVEN DUFFY, DC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-949-0434
Mailing Address - Street 1:4430 NW 50TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2295
Mailing Address - Country:US
Mailing Address - Phone:405-949-0434
Mailing Address - Fax:405-949-0330
Practice Address - Street 1:4430 NW 50TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2295
Practice Address - Country:US
Practice Address - Phone:405-949-0434
Practice Address - Fax:405-949-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3568251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK235431500Medicare ID - Type UnspecifiedCHIROPRACTIC
OKU86465Medicare UPIN