MEDICARE: MR. JOSEF KAY BURWELL PA-C

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
1	363AM0700X	Medical Physician Assistant
2	207P00000X	Emergency Medicine Physician	1915	AZ

General Provider Information

NPI Number	:	1316925886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEF KAY BURWELL PA-C

Provider Business Mailing Address
First Line	:	2322 N 8TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-1610
Country	:	US
Telephone Number	:	602-909-0404
Fax Number	:	602-548-2292

Provider Business Practice Location Address
First Line	:	2902 W CLARENDON AV
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85209
Country	:	US
Telephone Number	:	602-909-0404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	06/23/2016

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