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Individual

ALLAN SCOTT BURNSIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
507 CENTRAL AVE, DOLORES, CO 81323
(970) 882-7221
(970) 882-7221
Mailing address
PO BOX 908, DOLORES, CO 81323-0908
(970) 882-7221
(970) 882-4243

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32885
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01328855
CO
01
080053393
RAILROAD MEDICARE
CO
01
12635871
RURAL HEALTH CLINIC
CO
01
5502AMGR004393
ANTHEM
CO
Enumeration date
01/19/2006
Last updated
07/13/2010
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