Healthcare Provider Details

I. General information

NPI: 1316925886
Provider Name (Legal Business Name): JOSEF KAY BURWELL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PAMELA BURWELL PA-C

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 W CLARENDON AV
PHOENIX AZ
85209
US

IV. Provider business mailing address

2322 N 8TH ST
PHOENIX AZ
85006-1610
US

V. Phone/Fax

Practice location:
  • Phone: 602-909-0404
  • Fax:
Mailing address:
  • Phone: 602-909-0404
  • Fax: 602-548-2292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1915
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: