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General NPI Number Information
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NPI Number | 1063492593
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Entity Type | Individual
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Provider Name | JAMES W BURHOP MD
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 17000 W NORTH AVE STE 107W
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City | BROOKFIELD
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State | WI
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Zip | 53005-4423
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Country | US
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Telephone | 262-786-3722
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Fax | 262-786-0116
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Provider Business Mailing Address
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Address Line | 17000 W NORTH AVE STE 107W
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City | BROOKFIELD
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State | WI
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Zip | 53005-4423
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Country | US
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Telephone | 262-786-3722
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Fax | 262-786-0116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 28493-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 28493-020
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 28493
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License Number State | WI
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