Healthcare Provider Details

I. General information

NPI: 1437353893
Provider Name (Legal Business Name): MARCIA L DURHAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARCIA L COLLINS PHARMD

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 E WASHINGTON ST
IDABEL OK
74745-7852
US

IV. Provider business mailing address

1907 E WASHINGTON ST
IDABEL OK
74745-7852
US

V. Phone/Fax

Practice location:
  • Phone: 580-286-3323
  • Fax: 580-286-2396
Mailing address:
  • Phone: 580-286-3323
  • Fax: 580-286-2396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1453
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14623
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: