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NPI Code Detail

MEDICARE: MR. JEREMY ROSS DURLING MD

MEDICARE: MR. JEREMY ROSS DURLING MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD2017-0837NM

General Provider Information

NPI Number : 1760861157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEREMY ROSS DURLING MD
Provider Business Mailing Address
First Line : 6420 CLAYTON ROAD
Second Line :
City : ST LOUIS
State : MO
Zip : 63117
Country : US
Telephone Number : 314-768-8778
Fax Number : 314-768-7101
Provider Business Practice Location Address
First Line : 2400 UNSER BLVD SE
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-3392
Country : US
Telephone Number : 505-253-1183
Fax Number : 505-253-1199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2015
Last Update Date : 08/21/2024

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