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General NPI Number Information
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NPI Number | 1700078896
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES DURKIN DO
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Gender | Male
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 2300 E 30TH ST STE 101
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City | FARMINGTON
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State | NM
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Zip | 87401-8990
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Country | US
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Telephone | 505-208-6280
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Fax | 505-564-3202
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Provider Business Mailing Address
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Address Line | PO BOX 160
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City | SHIPROCK
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State | NM
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Zip | 87420-0160
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Country | US
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Telephone | 505-368-6001
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS14541
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | CDRH.0055714
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | A-1501-09
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License Number State | NM
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