Healthcare Provider Details

I. General information

NPI: 1932547338
Provider Name (Legal Business Name): PAULA JEAN DURST DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 W TARGET RANGE RD
NOGALES AZ
85621-2415
US

IV. Provider business mailing address

7551 E ARBOR AVE
MESA AZ
85208-1219
US

V. Phone/Fax

Practice location:
  • Phone: 520-285-3000
  • Fax:
Mailing address:
  • Phone: 608-354-5399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number10483
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: