Healthcare Provider Details

I. General information

NPI: 1942253075
Provider Name (Legal Business Name): DANIEL L. BURKHEAD, MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9920 W CHEYENNE AVE #110
LAS VEGAS NV
89129-7725
US

IV. Provider business mailing address

9920 W CHEYENNE AVE #110
LAS VEGAS NV
89129-7725
US

V. Phone/Fax

Practice location:
  • Phone: 702-316-2281
  • Fax: 702-316-2272
Mailing address:
  • Phone: 702-316-2281
  • Fax: 702-316-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number9100
License Number StateNV

VIII. Authorized Official

Name: DR. DANIEL L BURKHEAD
Title or Position: OWNER
Credential: M.D.
Phone: 702-316-2281