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Individual

DR. MICHEAL J DURHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
755 COWAN DR, LEBANON, MO 65536-4629
(417) 532-2805
(417) 532-2848
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2010019729
MO
207Q00000X
Family Medicine Physician
4291
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1326005190
MO
Enumeration date
04/27/2006
Last updated
07/10/2025
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