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NPI Code Detail

MEDICARE: KERRY DEAN DURR

MEDICARE:   KERRY DEAN DURR
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
1183500000XPharmacistE-06618MS

General Provider Information

NPI Number : 1235733478
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY DEAN DURR
Provider Business Mailing Address
First Line : PO BOX 933
Second Line :
City : WAYNESBORO
State : MS
Zip : 39367-0933
Country : US
Telephone Number : 601-410-4466
Fax Number : 601-735-5202
Provider Business Practice Location Address
First Line : 1621 HIGHWAY 15 N
Second Line :
City : LAUREL
State : MS
Zip : 39440-2123
Country : US
Telephone Number : 601-649-4670
Fax Number : 601-735-5202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2020
Last Update Date : 11/29/2020

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Directions to “ KERRY DEAN DURR ” Practice Location

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