Individual
GREGORY E. BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1040 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-5000
(608) 847-9875
Mailing address
1040 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-5000
(608) 847-9875
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3023-23
WI
363AS0400X
Surgical Physician Assistant
Primary
3023-23
WI
Other
Enumeration date
09/05/2012
Last updated
01/24/2019
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