Provider Demographics
NPI:1942221395
Name:DURST, LORA L (OD)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:L
Last Name:DURST
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 SW 29TH ST
Mailing Address - Street 2:STE 400
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2022
Mailing Address - Country:US
Mailing Address - Phone:785-266-5544
Mailing Address - Fax:785-266-4381
Practice Address - Street 1:3300 SW 29TH ST
Practice Address - Street 2:STE 400
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2022
Practice Address - Country:US
Practice Address - Phone:785-266-5544
Practice Address - Fax:785-266-4381
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1440-3152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200001910AMedicaid
U41383Medicare UPIN
KS650922Medicare ID - Type Unspecified