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Individual

LISA K BURTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5201 YELLOWSTONE RD, CHEYENNE, WY 82009-4741
(307) 632-1114
(307) 632-9920
Mailing address
PO BOX 20970, CHEYENNE, WY 82003-7020
(307) 773-8012
(307) 633-7676

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35214
CO
208600000X
Surgery Physician
Primary
8731A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01352145
CO
Enumeration date
06/08/2006
Last updated
11/15/2022
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