Provider Demographics
NPI:1679768626
Name:DURAN, TIMOTHY RYAN VALOIS (PA-C)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RYAN VALOIS
Last Name:DURAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 S AVENUE A
Mailing Address - Street 2:HOSPITALIST DEPARTMENT
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7127
Mailing Address - Country:US
Mailing Address - Phone:928-336-1442
Mailing Address - Fax:928-336-7776
Practice Address - Street 1:2400 S AVENUE A
Practice Address - Street 2:HOSPITALIST DEPARTMENT
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7127
Practice Address - Country:US
Practice Address - Phone:928-336-1442
Practice Address - Fax:928-336-7776
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3673363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant