Healthcare Provider Details

I. General information

NPI: 1316139256
Provider Name (Legal Business Name): JOHN DAVID BURROW D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 NAT TURNER BLVD S
NEWPORT NEWS VA
23606-3074
US

IV. Provider business mailing address

2103 SANDRA RD
VOORHEES NJ
08043-2069
US

V. Phone/Fax

Practice location:
  • Phone: 757-596-1900
  • Fax: 757-591-8560
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0102203479
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: