Healthcare Provider Details

I. General information

NPI: 1104871896
Provider Name (Legal Business Name): MERCY REGIONAL MEDICAL CENTER OF DURANGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 THREE SPRINGS BLVD
DURANGO CO
81301-8296
US

IV. Provider business mailing address

1010 THREE SPRINGS BLVD
DURANGO CO
81301-8296
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-4311
  • Fax:
Mailing address:
  • Phone: 970-247-4311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: KIRK A DIGNUM
Title or Position: CEO PRESIDENT
Credential:
Phone: 970-247-4311