Individual
ADAM GLEN BURROUGHS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4221 S WESTERN AVE STE 2010, OKLAHOMA CITY, OK 73109-3445
(405) 644-5120
(405) 644-5309
Mailing address
920 STANTON L YOUNG BLVD # WP3010, OKLAHOMA CITY, OK 73104-5036
(405) 271-4742
(405) 271-2619
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10044544
TX
207R00000X
Internal Medicine Physician
Q5769
TX
207RC0000X
Cardiovascular Disease Physician
31974
OK
207RI0011X
Interventional Cardiology Physician
Primary
31974
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200654080A
—
OK
Enumeration date
05/10/2012
Last updated
08/27/2020
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