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General NPI Number Information
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NPI Number | 1922569672
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Entity Type | Organization
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Legal Business Name | ANDREW H BURGON PODIATRY LLC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1761 N 2000 W STE 6
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City | FARR WEST
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State | UT
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Zip | 84404-9541
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Country | US
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Telephone | 801-564-1562
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Fax | 801-689-2594
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Provider Business Mailing Address
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Address Line | 1761 N 2000 W STE 6
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City | FARR WEST
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State | UT
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Zip | 84404-9541
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Country | US
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Telephone | 801-564-1562
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Fax | 801-689-2594
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Authorized Official
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Title or Position | DPM/OWNER
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Name | ANDREW HARRIS BURGON
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Credential | DPM
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Telephone | 435-760-7313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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