Healthcare Provider Details

I. General information

NPI: 1346273208
Provider Name (Legal Business Name): DAVID J DURKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 2ND AVENUE WEST N STE 101A
KALISPELL MT
59901-3910
US

IV. Provider business mailing address

180 LIBERTY ST
BOALSBURG PA
16827-1031
US

V. Phone/Fax

Practice location:
  • Phone: 570-246-3921
  • Fax:
Mailing address:
  • Phone: 570-246-3921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD032407E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number77074
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: