Provider Demographics
NPI:1760782049
Name:CNOS, PC
Entity Type:Organization
Organization Name:CNOS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BOARD OF DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DURWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-217-2667
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-1430
Mailing Address - Country:US
Mailing Address - Phone:605-217-2667
Mailing Address - Fax:605-217-2900
Practice Address - Street 1:211 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SAC CITY
Practice Address - State:IA
Practice Address - Zip Code:50583-2424
Practice Address - Country:US
Practice Address - Phone:605-217-2667
Practice Address - Fax:605-217-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA47935Medicare PIN
IA1295480003Medicare NSC