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NPI Code Detail

MEDICARE: JOHN DURDEN D.O., FACEP

MEDICARE: JOHN DURDEN D.O., FACEP
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
1207P00000XEmergency Medicine PhysicianF5524TX
2207P00000XEmergency Medicine Physician1847OK

General Provider Information

NPI Number : 1841217395
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DURDEN D.O., FACEP
Provider Business Mailing Address
First Line : PO BOX 841687
Second Line :
City : DALLAS
State : TX
Zip : 75284-1687
Country : US
Telephone Number : 866-916-5259
Fax Number : 231-922-4030
Provider Business Practice Location Address
First Line : 110 MEMORIAL HOSPITAL DR
Second Line :
City : HUNTSVILLE
State : TX
Zip : 77340-4940
Country : US
Telephone Number : 936-291-3411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 02/19/2008

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Directions to “ JOHN DURDEN D.O., FACEP” Practice Location

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