Provider Demographics
NPI:1578734356
Name:JOHN A DURKAN MD PC
Entity Type:Organization
Organization Name:JOHN A DURKAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DURKAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-386-1818
Mailing Address - Street 1:902 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1538
Mailing Address - Country:US
Mailing Address - Phone:541-386-1818
Mailing Address - Fax:541-386-3225
Practice Address - Street 1:902 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1538
Practice Address - Country:US
Practice Address - Phone:541-386-1818
Practice Address - Fax:541-386-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14647207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00205331OtherRAILROAD MEDICARE
R130841Medicare PIN
5534440001Medicare NSC