Provider Demographics
NPI:1497983787
Name:DURBIN, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:DURBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 955534
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-5534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1035 BELLEVUE AVE
Practice Address - Street 2:400
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1854
Practice Address - Country:US
Practice Address - Phone:314-925-4700
Practice Address - Fax:314-925-4751
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2014009218207R00000X
MO2009010808207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine