Individual
DR. LAURA L BURGOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
262 DANNY THOMAS PLACE, MS 0515, C/O DANA CANNON, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
39502
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009931936
—
AL
05
—
06126056
—
MS
05
—
158595001
—
AR
05
—
177498601
—
TX
05
—
200058900A
—
OK
05
—
200378350A
—
KS
05
—
200529130A
—
IN
05
—
207369208
—
MO
05
—
5440585
—
TN
05
—
64101025
—
KY
Enumeration date
06/27/2005
Last updated
04/05/2011
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