Provider Demographics
NPI:1114986502
Name:TOWNSEND, DUANE EVERETT (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:EVERETT
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 RYANS LN
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:UT
Mailing Address - Zip Code:84049-6702
Mailing Address - Country:US
Mailing Address - Phone:435-657-2047
Mailing Address - Fax:435-657-2137
Practice Address - Street 1:112 RYANS LN
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:UT
Practice Address - Zip Code:84049-6702
Practice Address - Country:US
Practice Address - Phone:435-901-8123
Practice Address - Fax:435-657-2137
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT186955-1205207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTA21850Medicare UPIN
UT000010531Medicare ID - Type Unspecified