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CHARLES HENRY DURDEN MD
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1598842031
Individual Registrant: CHARLES HENRY DURDEN MD
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
110 NORMAN DORMINY DR SUITE A FITZGERALD, GA 31750-8858 US
Tel: 229-423-4333 Fax: 229-423-0928
Tel: 229-423-4333 Fax: 229-423-0928
Contact information for business:
PO BOX 480 FITZGERALD, GA 31750-0480 US
Tel: 229-423-4333 Fax: 229-423-0928
Tel: 229-423-4333 Fax: 229-423-0928
Registration Information:
NPI: 1598842031
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | GA | 011322 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 00015056A | GA | 05 |
