Organization
JOHN R. BURROUGHS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R BURROUGHS MD (OWNER)
(719) 473-8801
Entity
Organization
Contact information
Practice address
300 GARDEN OF THE GODS, STE. 100, COLORADO SPRINGS, CO 80907
(719) 473-8801
(719) 473-8581
Mailing address
300 GARDEN OF THE GODS, STE. 100, COLORADO SPRINGS, CO 80907-6267
(719) 473-8801
(719) 473-8581
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
44251
CO
2086S0122X
Plastic and Reconstructive Surgery Physician
44251
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21637229
—
CO
01
—
44251
LICENCE NUMBER
CO
01
—
C811678
MEDICARE PTAN
CO
01
—
DF0561
RR MCR
CO
Enumeration date
11/20/2007
Last updated
11/19/2019
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