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Individual

BOURCK D CASHMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1840 N JASPER DR STE 2, FLAGSTAFF, AZ 86001-1634
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
30819
AZ
207X00000X
Orthopaedic Surgery Physician
Primary
30819
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
727381
AZ
Enumeration date
01/31/2006
Last updated
02/28/2024
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