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General NPI Number Information
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NPI Number | 1255518007
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Entity Type | Individual
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Provider Name | RANDY EDWARD DURBIN DO
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Gender | Male
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 2001 HIGHLAND AVE
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City | KNOXVILLE
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State | TN
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Zip | 37916-1217
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Country | US
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Telephone | 865-633-0353
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Fax |
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Provider Business Mailing Address
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Address Line | 2077 GRANGEHILL WAY
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City | CUMMING
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State | GA
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Zip | 30041-6204
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Country | US
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Telephone | 404-402-2078
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2024-01606
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 64776
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 03371
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 64776
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DO0000003188
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License Number State | TN
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