Healthcare Provider Details

I. General information

NPI: 1245264936
Provider Name (Legal Business Name): LORA L. DURST, O.D., L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SW 37TH ST
TOPEKA KS
66611-2308
US

IV. Provider business mailing address

5731 SW 33RD CT
TOPEKA KS
66614-4564
US

V. Phone/Fax

Practice location:
  • Phone: 785-266-5544
  • Fax: 785-266-4381
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1440-3
License Number StateKS

VIII. Authorized Official

Name: DR. LORA L. DURST
Title or Position: OWNER/MANAGER
Credential: O.D.
Phone: 785-215-2112