| Doctor Name: | ROBERT ELDO DURRETT |
| NPI Number: | 1023375698 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 00024330 |
| Business Practice Address: | 140 Old Mill Rd Clarksville, TN - 370423109 |
| Business Phone Number: | 9315520858 |
| Business Fax Number: | 9316451923 |
| Mailing Address: | Po Box 2308, CLARKSVILLE |
| State: | TN |
| Postal Code: | 370422308 |
| Phone Number: | 9315520858 |
| Fax Number: | 9316451923 |
| NPI Enumeration Date: | 04/19/2012 |
| NPI Last Update Date: | 04/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | 00024330 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |