Individual ProviderDustin DurhamFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1705 W Main St, Mesa, AZ 85201-6920(480) 964-2273PECOS EnrollmentBased on the most recent information from CMS, provider Dustin Durham is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1740694397Provider TypeIndividualFull NameDurham, DustinCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date6/11/2014Last Updated9/29/2023Contact InformationPractice LocationPractice Address1705 W Main St, Mesa, AZ 85201-6920Phone(480) 964-2273FaxUnlisted FaxMailing LocationMailing Address3033 N Central Ave Ste 145, Phoenix, AZ 85012-2808Phone(480) 964-2273FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense69739ArizonaProvider IdentifiersIDDescriptionIssuerID69739DescriptionOtherIssuerARIZONA MEDICAL BOARDArizona