MEDICARE: JULIE ROSS DURAND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	021360	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	100037646	OTHER	PHP
2	1265110	OTHER	CIGNA
3	4100385	OTHER	AETNA
4	TN0113	OTHER	JOHN DEERE
5	4097416	OTHER	BLUE CROSS BLUE SHIELD
6	0943434	OTHER	UNITED HEALTHCARE
7	3333333	OTHER	UMWA

General Provider Information

NPI Number	:	1174592984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ROSS DURAND M.D.

Provider Business Mailing Address
First Line	:	1932 ALCOA HWY STE 255
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-1508
Country	:	US
Telephone Number	:	865-220-2030
Fax Number	:	865-684-1196

Provider Business Practice Location Address
First Line	:	622 SMITHVIEW DR
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37803-6100
Country	:	US
Telephone Number	:	865-681-1234
Fax Number	:	865-982-9746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	01/31/2019

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