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Individual

KRAIG M BURGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
18555 N 79TH AVE STE E101, GLENDALE, AZ 85308-8392
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4169
AZ
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
4169
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
954348
AZ
Enumeration date
10/25/2005
Last updated
07/25/2022
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