National Provider Identifier
Madison D Durham, PA
Madison D Durham, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Lockport, NY and a listed phone number of (716) 986-9199.
Profile Overview
- NPI
- 1225707466
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- September 10, 2021
- Last Updated
- January 29, 2024
Practice Location
- 38 Heritage Ct
- Lockport, NY 14094-3616
Phone: (716) 986-9199
Mailing Address
- 501 S 5Th Ave
- Yakima, WA 98902-3550
Specialties
- Physician Assistant (363A00000X)
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1225707466
- Entity Type
- Individual
- Last Name
- Durham
- First Name
- Madison
- Middle Name
- D
- Credential
- PA
- Provider Other Last Name
- Verrall
- Provider Other First Name
- Madison
- Provider Other Middle Name
- D
- Provider Other Credential Text
- PA
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 501 S 5Th Ave
- Mailing City
- Yakima
- Mailing State
- WA
- Mailing ZIP Code
- 98902-3550
- Mailing Country
- US
- Mailing Phone
- (509) 853-1082
- Mailing Fax
- (509) 853-1082
- Practice Street Address
- 38 Heritage Ct
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-3616
- Practice Country
- US
- Practice Phone
- (716) 986-9199
- Practice Fax
- (716) 304-1044
- Enumeration Date
- September 10, 2021
- Last Updated
- January 29, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 29, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X), Physician Assistant (363A00000X)
- Other Identifiers
- 2188015 (WA)