Doctor Name: | MR. JOSEPH DURANT |
NPI Number: | 1376960179 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT, BA |
License Number: | MT003512 |
Business Practice Address: | 1111 Glynco Pkwy Ste. 400 Brunswick, GA - 315257921 |
Business Phone Number: | 9122694534 |
Business Fax Number: | |
Mailing Address: | 107 Mackay Cir, BRUNSWICK |
State: | GA |
Postal Code: | 315254525 |
Phone Number: | 9122694534 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2014 |
NPI Last Update Date: | 03/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MT003512 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |