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Individual

PHILLIP WAYNE DURAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12687 W CEDAR DR, 200, LAKEWOOD, CO 80228-2010
(575) 623-4844
(575) 625-9951
Mailing address
12687 W CEDAR DR, 200, LAKEWOOD, CO 80228-2010
(575) 623-4844
(575) 625-9951

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A-922-90
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
F7074
NM
Enumeration date
05/17/2006
Last updated
07/02/2012
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