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General NPI Number Information
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NPI Number | 1649360728
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Entity Type | Individual
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Provider Name | CATHERINE ELIZABETH DURBORAW M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 2375 E SUNNYSIDE RD STE G
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City | IDAHO FALLS
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State | ID
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Zip | 83404-8281
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Country | US
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Telephone | 208-529-8232
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Fax | 208-542-1150
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Provider Business Mailing Address
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Address Line | 2375 E SUNNYSIDE RD STE G
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City | IDAHO FALLS
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State | ID
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Zip | 83404-8281
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Country | US
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Telephone | 208-529-8232
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Fax | 208-542-1150
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | M-7457
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | M7457
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License Number State | ID
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