Healthcare Provider Details

I. General information

NPI: 1487663720
Provider Name (Legal Business Name): JEFFREY S BURWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JEFF BURWELL M.D.

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W NORFOLK AVE
NORFOLK NE
68701-4438
US

IV. Provider business mailing address

1500 KOENIGSTEIN AVE PO BOX 869
NORFOLK NE
68701-3664
US

V. Phone/Fax

Practice location:
  • Phone: 402-371-4880
  • Fax: 402-644-7432
Mailing address:
  • Phone: 402-644-7116
  • Fax: 402-644-7432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number22717
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: