Organization
ETOWAH FAMILY PRACTICE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES B DURKIN MD (OWNER)
(423) 263-4500
Entity
Organization
Contact information
Practice address
305 GRADY RD, SUITE A, ETOWAH, TN 37331-1903
(423) 263-4500
(423) 263-0045
Mailing address
305 GRADY RD, SUITE A, ETOWAH, TN 37331-1903
(423) 263-4500
(423) 263-0045
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000036878
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2308972
CIGNA
TN
05
—
3880122
—
TN
01
—
4051202
BCBS
TN
01
—
7892455
AETNA
TN
01
—
P00092170
RR MEDICARE
TN
01
—
TN0101
UHC/JD
TN
Enumeration date
02/28/2007
Last updated
11/21/2007
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