Healthcare Provider Details

I. General information

NPI: 1669337002
Provider Name (Legal Business Name): JAMES DONALD DURBIN II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

778 KLONDYKE RD APT F
RIPLEY WV
25271-5302
US

IV. Provider business mailing address

778 KLONDYKE RD APT F
RIPLEY WV
25271-5302
US

V. Phone/Fax

Practice location:
  • Phone: 304-531-6413
  • Fax:
Mailing address:
  • Phone: 304-531-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: