# DOCTORS CLINIC OF DURANT INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598850331
- **Authorized official:** MR. KOTESWAR RAO SUREDDI MD (OWNER)
- **Authorized official phone:** (580) 924-1700

## Contact information

- **Practice address:** 1400 BRYAN DR, SUITE 300, DURANT, OK 74701-2156
- **Practice address phone:** (580) 924-1700
- **Practice address fax:** (580) 924-1736
- **Mailing address:** 1400 BRYAN DR, SUITE 300, DURANT, OK 74701
- **Mailing address phone:** (580) 924-1700
- **Mailing address fax:** (580) 924-1736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11978 | OK | Yes |
| 207R00000X | Internal Medicine Physician | 23224 | OK | — |
| 207VG0400X | Gynecology Physician | 11979 | OK | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | OK | — |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 12/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100177390A | — | OK |
| 05 | — | 100733950B | — | OK |
| 05 | — | 200076210G | — | OK |