Doctor Name: | JASON DUREN |
NPI Number: | 1477942951 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A.-C |
License Number: | |
Business Practice Address: | 7050 Air Depot Blvd Bldg 1094 Tinker Afb, OK - 731458716 |
Business Phone Number: | 4055825233 |
Business Fax Number: | |
Mailing Address: | 7050 Air Depot Blvd Bldg 1094, TINKER AFB |
State: | OK |
Postal Code: | 731458716 |
Phone Number: | 4055825233 |
Fax Number: | |
NPI Enumeration Date: | 01/21/2015 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |