Provider Demographics
NPI:1639116015
Name:HURA, DONALD EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:EUGENE
Last Name:HURA
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 1:54 W. HIGH ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140
Mailing Address - Country:US
Mailing Address - Phone:740-490-7244
Mailing Address - Fax:740-490-7362
Practice Address - Street 1:54 W. HIGH ST.
Practice Address - Street 2:SUITE A
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140
Practice Address - Country:US
Practice Address - Phone:740-490-7244
Practice Address - Fax:740-490-7362
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35052450208600000X
OH35.052450208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4295317OtherAETNA PROVIDER NUMBER
OH1700244OtherUHC PROVIDER NUMBER
OH000000007601OtherBC/BS PROVIDER NUMBER
OH0632168Medicaid
000000634098OtherANTHEM
OH0776745Medicaid
OH4295317OtherAETNA PROVIDER NUMBER
OH0632168Medicaid
OH0776745Medicaid