DR. GUSTAVO DURAZO JR. (NPI# 1427600782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427600782 |
| Entity Type | Individual |
| Full Name | DR. GUSTAVO DURAZO JR. |
| Credential | DNP |
| Practice Address |
1100 N F Ave Douglas AZ 85607-1919 |
| Mailing Address |
1205 N F Ave Douglas AZ 85607-1920 |
| Practice Telephone | 5203643285 |
| Practice Fax Number | 5203644261 |
| Mailing Telephone | 5203646852 |
| Mailing Fax Number | 5203644261 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-11-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
229416 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 583256 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 942 W Calle Carasol, Tucson, AZ 857131680 | 5202664904 |
| Street Address |
1100 N F AVE |
| City | DOUGLAS |
| State | AZ |
| Zip Code | 85607-1919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144593997 | Paula B Bird | Social Worker | 1100 N F Ave, Douglas, AZ 85607-1919 | 2012-02-09 |
| 1578033809 | South Eastern Arizona Behavioral Health Services, Inc. | Community/Behavioral Health | 1100 N F Ave, Douglas, AZ 85607-1919 | 2018-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811472665 | Chiricahua Community Health Centers, Inc | Clinic/Center | 1151 16th Street, Douglas, AZ 85607 | 2018-09-27 |
| 1457758609 | Angela Leah Overturf | Nurse Practitioner | 100 East 5th Street, Douglas, AZ 85607 | 2014-12-02 |
| 1609279108 | Walter Tucker | Counselor | 2100 E 8th, Douglas, AZ 85607 | 2014-09-29 |
| 1851700488 | Gerardo Grijalva | Non-emergency Medical Transport (VAN) | 2714 E 6th St, Douglas, AZ 85607 | 2014-08-07 |
| 1174933246 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 1019 F Ave, Douglas, AZ 85607 | 2014-04-29 |
| 1831473164 | Cheryl Lynn Mcneeley | Speech-Language Pathologist | 815 E. 15th Street, Douglas, AZ 85607 | 2011-10-05 |
| 1245523364 | Community Intervention Associates | Community/Behavioral Health | 1701 North Douglasave, Douglas, AZ 85607 | 2011-05-23 |
| 1174820898 | Chiricahua Community Health Centers, Inc | Clinic/Center | 815 15th Street, Douglas, AZ 85607 | 2011-02-15 |
| 1033319512 | Community Healthcare of Douglas Inc | Clinic/Center | 1906 11th Street, Douglas, AZ 85607 | 2007-07-23 |
| 1538360888 | Jay Daniel Zamora | Chiropractor | 1915 E 10th St, Douglas, AZ 85607 | 2007-05-31 |
| Find all providers in zip 85607 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972667954 | Pamela K Turk | Nurse Practitioner | 200 Doctors Dr 106, Douglas, GA 31533-2202 | 2006-12-21 |
| 1225662216 | Sara Marie Thronburg | Nurse Practitioner | 111 S 5th St, Douglas, WY 82633-2434 | 2020-02-27 |
| 1225365976 | Michael S. Flory | Nurse Practitioner | 200 Doctors Dr Ste 106, Douglas, GA 31533-2202 | 2009-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864202 | Soma Care, LLC | Nurse Practitioner | 6944 E Broadway Rd Ste A, Mesa, AZ 85208-1916 | 2020-08-31 |
| 1497367403 | Daryl Lyons | Nurse Practitioner | 18095 W Santa Irene Dr, Goodyear, AZ 85338-5456 | 2020-08-20 |
| 1538787072 | Brijeshaben Urvish Patel | Nurse Practitioner | 13300 N 88th Ave Apt 2007, Peoria, AZ 85381-2614 | 2020-07-10 |
| 1043835424 | Us Live Clinic LLC | Nurse Practitioner | 12610 E Laurel Ln, Scottsdale, AZ 85259-3460 | 2020-06-11 |
| 1831713148 | Alexis Petra Md | Nurse Practitioner | 21835 N 51st St, Phoenix, AZ 85054-7140 | 2020-06-02 |
| 1245851955 | Amy Rachelle Dunn | Nurse Practitioner | 7563 E Plata Ave, Mesa, AZ 85212-9729 | 2020-05-04 |
| 1700407426 | Joan N Nunoo | Nurse Practitioner | 3852 E Santa Fe Ln, Gilbert, AZ 85297-8529 | 2020-05-04 |
| 1326675166 | Kendrick Wright | Nurse Practitioner | 2727 E Camelback Rd Apt 525, Phoenix, AZ 85016-4481 | 2020-03-23 |
| 1518591510 | Laura Larson | Nurse Practitioner | 1929 W Fillmore St Bldg C, Phoenix, AZ 85009-3812 | 2020-02-27 |
| 1538791512 | Silverleaf Health LLC | Nurse Practitioner | 20715 N Pima Rd Ste 108, Scottsdale, AZ 85255-6685 | 2020-02-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.