Healthcare Provider Details

I. General information

NPI: 1639116015
Provider Name (Legal Business Name): DONALD EUGENE HURA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 W. HIGH ST. SUITE A
LONDON OH
43140
US

IV. Provider business mailing address

54 W. HIGH ST. SUITE A
LONDON OH
43140
US

V. Phone/Fax

Practice location:
  • Phone: 740-490-7244
  • Fax: 740-490-7362
Mailing address:
  • Phone: 740-490-7244
  • Fax: 740-490-7362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35052450
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.052450
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: