Individual
MRS. KELLY M DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4021 BALMORAL DR SW, HUNTSVILLE, AL 35801-6403
(256) 539-2741
(256) 539-2775
Mailing address
4021 BALMORAL DR SW, HUNTSVILLE, AL 35801-6403
(256) 539-2741
(256) 539-2775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA437
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51531165
BC BS
AL
Enumeration date
05/10/2006
Last updated
04/21/2009
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