1508844317 NPI number — DR. DONALD L BURROWS MD

Table of content: DR. DONALD L BURROWS MD (NPI 1508844317)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508844317 NPI number — DR. DONALD L BURROWS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURROWS
Provider First Name:
DONALD
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508844317
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 NW 114TH ST
Provider Second Line Business Mailing Address:
SUITE 347
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50325-7046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-224-1777
Provider Business Mailing Address Fax Number:
515-222-0226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 NW 114TH ST
Provider Second Line Business Practice Location Address:
SUITE 347
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50325-7046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-224-1777
Provider Business Practice Location Address Fax Number:
515-222-0226
Provider Enumeration Date:
01/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  24071 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RS0012X , with the licence number: 24071 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 849690 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0020982 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25922 . This is a "WELLMARK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 76222 . This is a "COVENTRY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 35347 . This is a "MIDLAND'S CHOICE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: IA0101 . This is a "UHC OF THE RIVER VALLEY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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