Provider Demographics
NPI:1861522955
Name:DUFFY, JAMES LAWRENCE (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LAWRENCE
Last Name:DUFFY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 COBB PKWY N
Mailing Address - Street 2:SUITE 128
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-3585
Mailing Address - Country:US
Mailing Address - Phone:770-485-6554
Mailing Address - Fax:
Practice Address - Street 1:200 COBB PKWY N
Practice Address - Street 2:SUITE 128
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-3585
Practice Address - Country:US
Practice Address - Phone:770-485-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005136111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAT64324Medicare UPIN