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General NPI Number Information
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NPI Number | 1467667626
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Entity Type | Organization
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Legal Business Name | JOSE I DURAN MD PC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 494 N. CARONDELET DR.
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City | NOGALES
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State | AZ
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Zip | 85621-2453
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Country | US
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Telephone | 520-761-1603
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Fax | 520-287-4471
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Provider Business Mailing Address
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Address Line | 494 N CARONDELET DR
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City | NOGALES
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State | AZ
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Zip | 85621-2453
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Country | US
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Telephone | 520-761-1603
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Fax | 520-287-4471
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE I DURAN
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Credential | M.D.
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Telephone | 520-761-1603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 14385AZ
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License Number State | AZ
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