Healthcare Provider Details

I. General information

NPI: 1568807022
Provider Name (Legal Business Name): KEVEN SCOTT BURNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9735 N 90TH PL
SCOTTSDALE AZ
85258
US

IV. Provider business mailing address

9735 N 90TH PL
SCOTTSDALE AZ
85258-5067
US

V. Phone/Fax

Practice location:
  • Phone: 480-222-4954
  • Fax: 480-210-5460
Mailing address:
  • Phone: 480-222-4954
  • Fax: 22-976-5566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number30037
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number55480
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: