Healthcare Provider Details

I. General information

NPI: 1861905747
Provider Name (Legal Business Name): PAUL JOSEPH DURRANT C-AA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 STATE ST
NEW ALBANY IN
47150-4990
US

IV. Provider business mailing address

29 STANTON DR
SPRINGBORO OH
45066-8632
US

V. Phone/Fax

Practice location:
  • Phone: 812-944-7701
  • Fax:
Mailing address:
  • Phone: 937-885-3405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number67.000494
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: