Individual
VIKRAM DURAIRAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4010 S MULBERRY ST, PINE BLUFF, AR 71603-7000
(870) 541-6010
Mailing address
4010 S MULBERRY ST, PINE BLUFF, AR 71603-7000
(870) 541-6010
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Q4391
TX
207Q00000X
Family Medicine Physician
Primary
E-7644
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348429703
—
TX
05
—
348429704
—
TX
01
—
8FG872
BCBS
TX
Enumeration date
04/15/2009
Last updated
09/02/2016
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