MEDICARE: MS. TARA M BURTON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	1422	CO

General Provider Information

NPI Number	:	1194773531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TARA M BURTON PA

Provider Business Mailing Address
First Line	:	1975 RESEARCH PKWY STE 165
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1026
Country	:	US
Telephone Number	:	192-977-2797
Fax Number	:	719-574-6574

Provider Business Practice Location Address
First Line	:	1975 RESEARCH PKWY STE 165
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1026
Country	:	US
Telephone Number	:	192-977-2797
Fax Number	:	719-574-6574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	01/10/2025

Similar Medicare Providers

1801881941 — CHRISTOPHER R SARTORI M.D.
Practice Location Address:

1975 RESEARCH PKWY STE 165
COLORADO SPGS, CO
80920-1026

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1427043579 — BRETT K MATHESON M.D., FACMS
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1975 RESEARCH PKWY STE 165
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80920-1026

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Practice Location Address:

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1437208154 — PARACLAYSIS
Practice Location Address:

3110 BOYCHUCK AVE , SUITE K
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80910-1026

Practice Phone: 719-210-9744
Practice Fax: 719-302-2356

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