Provider Demographics
NPI:1184013138
Name:DUERR SURGICAL, LLC
Entity Type:Organization
Organization Name:DUERR SURGICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-347-0639
Mailing Address - Street 1:1008 BOLL WEEVIL CIR STE D
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-3400
Mailing Address - Country:US
Mailing Address - Phone:334-347-0639
Mailing Address - Fax:334-347-1021
Practice Address - Street 1:1008 BOLL WEEVIL CIR STE D
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-3400
Practice Address - Country:US
Practice Address - Phone:334-347-0639
Practice Address - Fax:334-347-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL51599852208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I931824Medicare PIN