Organization
RADIOLOGY ASSOCIATES OF DURANGO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WALTERS MD (OWNER)
(970) 259-2525
Entity
Organization
Contact information
Practice address
1010 THREE SPRINGS BLVD, DURANGO, CO 81301-8296
(970) 764-2286
Mailing address
PO BOX 394, GRETNA, NE 68028-0394
(877) 406-2976
(719) 591-2745
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04005427
—
CO
05
—
10025313600
—
CA
01
—
209463
US DEPARTMENT OF LABOR
—
05
—
825698
—
AZ
05
—
E2677
—
NM
01
—
RAB6508
BLUE CROSS BLUE SHIELD
CO
05
—
X9X000484
—
TX
Enumeration date
03/08/2007
Last updated
07/07/2015
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