Healthcare Provider Details
I. General information
NPI: 1053433441
Provider Name (Legal Business Name): TIMOTHY S DUERLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
304 OSLOSKI RD
EUREKA MT
59917-9217
US
IV. Provider business mailing address
5450 S GREEN ST
MURRAY UT
84123-5632
US
V. Phone/Fax
- Phone: 406-297-3145
- Fax: 406-297-3364
- Phone: 801-486-4877
- Fax: 801-214-7677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 144979 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 14081 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: