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General NPI Number Information
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NPI Number | 1487657730
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Entity Type | Individual
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Provider Name | DAVID R BURGIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 100 WINSLOW BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70508
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Country | US
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Telephone | 337-988-6858
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Fax | 337-988-6858
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Provider Business Mailing Address
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Address Line | 2644 S SHERWOOD FOREST BLVD STE 121
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City | BATON ROUGE
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State | LA
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Zip | 70816-2248
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Country | US
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Telephone | 225-293-2523
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Fax | 225-293-1807
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 015633
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License Number State | LA
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