Provider Demographics
NPI:1073549622
Name:DURLAND, SAMANTHA K (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:K
Last Name:DURLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1112 W 6TH ST
Mailing Address - Street 2:SUITE 210B
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2215
Mailing Address - Country:US
Mailing Address - Phone:785-393-5171
Mailing Address - Fax:866-623-6413
Practice Address - Street 1:1112 W 6TH ST
Practice Address - Street 2:SUITE 210B
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2215
Practice Address - Country:US
Practice Address - Phone:785-393-5171
Practice Address - Fax:866-623-6413
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30061207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100642110AMedicaid
KSH85937Medicare UPIN
KSH85937Medicare UPIN