Individual
JOSHUA DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8921 W HACKAMORE DR, BOISE, ID 83709-1673
(208) 994-4123
Mailing address
8921 W HACKAMORE DR, BOISE, ID 83709-1673
(208) 994-4123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-0684
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007018939
LICENSE
CO
01
—
PENDING
LICENSE
KS
Enumeration date
01/30/2008
Last updated
12/21/2023
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