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General NPI Number Information
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NPI Number | 1063634293
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Entity Type | Individual
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Provider Name | TODD ALVIN DURHAM D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 205 MARENGO ST
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City | FLORENCE
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State | AL
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Zip | 35630-6033
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Country | US
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Telephone | 256-381-0400
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Fax | 256-386-0065
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Provider Business Mailing Address
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Address Line | PO BOX 229
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City | SHEFFIELD
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State | AL
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Zip | 35660-0229
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Country | US
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Telephone | 256-381-0400
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Fax | 256-386-0065
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DO1067
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License Number State | AL
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