MEDICARE: MR. JAMES DOUGLAS BURROWS M.D., FRCS (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	174400000X	Specialist	2749521205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1186960001	OTHER	UT	CIGNA-DMERC ID#

General Provider Information

NPI Number	:	1477506913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES DOUGLAS BURROWS M.D., FRCS (C)

Provider Business Mailing Address
First Line	:	4052 PIONEER PKWY
Second Line	:	SUITE 208
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-2062
Country	:	US
Telephone Number	:	801-966-3977
Fax Number	:	801-966-4043

Provider Business Practice Location Address
First Line	:	4052 PIONEER PKWY
Second Line	:	SUITE 208
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-2062
Country	:	US
Telephone Number	:	801-966-3977
Fax Number	:	801-966-4043

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/11/2007

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