Individual
DR. MATTHEW EVAN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2855 MAIN AVE, STE A103, DURANGO, CO 81301-5956
(970) 382-8970
(970) 382-8966
Mailing address
215 W 26TH ST, DURANGO, CO 81301-5913
(505) 321-6703
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2950
CO
152W00000X
Optometrist
628
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87787857
—
NM
Enumeration date
09/10/2008
Last updated
05/02/2013
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