Provider Demographics
NPI:1114917127
Name:DURFEE, LYNN DWAYNE (O D)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:DWAYNE
Last Name:DURFEE
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5790 W 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-7340
Mailing Address - Country:US
Mailing Address - Phone:303-421-4422
Mailing Address - Fax:303-431-1457
Practice Address - Street 1:14991 E HAMPDEN AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3983
Practice Address - Country:US
Practice Address - Phone:303-963-9561
Practice Address - Fax:303-963-0713
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08918005Medicaid
CO08918005Medicaid
CO08918005Medicaid