Provider Demographics
NPI:1346273208
Name:DURKIN, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:DURKIN
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 1:180 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1031
Mailing Address - Country:US
Mailing Address - Phone:570-246-3921
Mailing Address - Fax:
Practice Address - Street 1:285 2ND AVENUE WEST N STE 101A
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3910
Practice Address - Country:US
Practice Address - Phone:570-246-3921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT77074207LA0401X
PAMD032407E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA439269OtherHIGHMARK BLUE SHIELD
PA2593OtherGEISINGER HEALTH PLAN
PA050062824OtherRAILROAD MEDICARE
PA0010947450001OtherPA MEDICAL ASSISTANCE
PA01822701OtherKEYSTONE HEALTH PLAN CENT
PA01822701OtherCAPITAL BLUE CROSS
PA439269OtherHIGHMARK BLUE SHIELD
PA01822701OtherKEYSTONE HEALTH PLAN CENT