Basic Information
| Provider Information | |||||||||
| NPI: | 1053369595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DURMON | ||||||||
| FirstName: | BEUFORD | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2233 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814013831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702493700 | ||||||||
| FaxNumber: | 9702498421 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 N HENSON ST | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709442331 | ||||||||
| FaxNumber: | 9709442320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 04/28/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35678 | CO | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 35678 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1356781 | 05 | CO | MEDICAID |