Provider Demographics
NPI:1891145728
Name:DURRANT, BROC A (MD)
Entity Type:Individual
Prefix:DR
First Name:BROC
Middle Name:A
Last Name:DURRANT
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:PO BOX 800022
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0022
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6670
Practice Address - Street 1:3000 N TRIUMPH BLVD STE 110
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-7186
Practice Address - Country:US
Practice Address - Phone:385-345-3555
Practice Address - Fax:385-345-3554
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311714208600000X, 208600000X
UT12656088-1205208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery