Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 34923 | AZ |
NPI | 1013940485 |
---|---|
Provider Name | Mary Kay Durfee |
First Address | Tucson, AZ 85741-3118 |
Second Address | Tucson, AZ 85741-3118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
084125 | (05) | AZ |
34923 | AZ MEDICAL BOARD (01) | AZ |
H38465 | (02) | MN |