Provider Demographics
NPI:1881717767
Name:DURHAM, DAVID JONATHAN (CP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JONATHAN
Last Name:DURHAM
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2221 E RACE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4727
Mailing Address - Country:US
Mailing Address - Phone:501-368-0868
Mailing Address - Fax:501-368-0003
Practice Address - Street 1:2221 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4727
Practice Address - Country:US
Practice Address - Phone:501-368-0868
Practice Address - Fax:501-368-0003
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist