Individual
DUANE LEE FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2373 G RD STE 100, GRAND JUNCTION, CO 81505
(970) 245-0484
(970) 241-1681
Mailing address
PO BOX 2608, GRAND JUNCTION, CO 81502-2608
(970) 263-2619
(970) 263-2691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAL-2390
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85629375
—
CO
01
—
P00638187
RR MEDICARE PIN
CO
Enumeration date
02/15/2007
Last updated
10/14/2019
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