Individual
MR. MEMIE CLIFTON BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
4212 N 16TH STREET, PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1637
Mailing address
P O BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1511
(602) 263-1637
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
30399
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413849
—
AZ
01
—
AZ0721580
BCBSAZ
AZ
Enumeration date
10/03/2006
Last updated
07/09/2007
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