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NPI Code Detail

MEDICARE: MARK BURROFF DO INC

MEDICARE: MARK BURROFF DO INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician379NV

General Provider Information

NPI Number : 1083046478
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK BURROFF DO INC
Provider Business Mailing Address
First Line : 2110 E FLAMINGO RD STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5192
Country : US
Telephone Number : 702-733-9009
Fax Number : 702-733-8378
Provider Business Practice Location Address
First Line : 2110 E FLAMINGO RD STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5192
Country : US
Telephone Number : 702-733-9009
Fax Number : 702-733-8378
Authorized Official
Title or Position : PRESIDENT
Name : MARK D BURROFF
Credential : DO
Telephone Number : 702-733-9009
Provider Enumeration Date : 08/07/2013
Last Update Date : 08/07/2013

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