Healthcare Provider Details

I. General information

NPI: 1588199400
Provider Name (Legal Business Name): WILLIAM DURKIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10238 E HAMPTON AVE STE 301A
MESA AZ
85209-3322
US

IV. Provider business mailing address

10238 E HAMPTON AVE STE 301A
MESA AZ
85209-3322
US

V. Phone/Fax

Practice location:
  • Phone: 602-553-3113
  • Fax:
Mailing address:
  • Phone: 602-553-3113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number009599
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: