Healthcare Provider Details

I. General information

NPI: 1457260820
Provider Name (Legal Business Name): DURANGO DERMATOLOGY AND DERMATOLOGIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 SUTTLE ST UNIT L
DURANGO CO
81303-6829
US

IV. Provider business mailing address

523 S CAMINO DEL RIO STE B
DURANGO CO
81303-6853
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-1970
  • Fax:
Mailing address:
  • Phone: 970-247-1970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE FISHER
Title or Position: OFFICE MANAGER
Credential:
Phone: 970-385-6337