MEDICARE: DR. BRIAN JEFFREY BURNS M.D.

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	207R00000X	Internal Medicine Physician	CDRH.0058074	CO
2	207R00000X	Internal Medicine Physician	40565	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407058423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN JEFFREY BURNS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 650823
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0823
Country	:	US
Telephone Number	:	720-264-5619
Fax Number	:

Provider Business Practice Location Address
First Line	:	6256 OXFORD PEAK CT
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-9467
Country	:	US
Telephone Number	:	720-923-2344
Fax Number	:	720-367-0283

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

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	11/01/2024

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