Individual
RONALD GARY DUERKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 NORTH 300 WEST, SUITE 416, PROVO, UT 84604-3354
(801) 357-7770
(801) 357-7639
Mailing address
1055 NORTH 300 WEST, SUITE 416, PROVO, UT 84604-3354
(801) 357-7770
(801) 357-7639
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1587841205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05263
—
UT
Enumeration date
10/18/2006
Last updated
07/08/2007
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