MEDICARE: JANE A BURNHAM MD PHD

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	2084N0400X	Neurology Physician	29559	CO

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	:	1710913751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE A BURNHAM MD PHD

Provider Business Mailing Address
First Line	:	7180 E ORCHARD RD
Second Line	:	SUITE 204
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-1724
Country	:	US
Telephone Number	:	303-788-7440
Fax Number	:	303-788-4633

Provider Business Practice Location Address
First Line	:	7180 E ORCHARD RD
Second Line	:	SUITE 204
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-1724
Country	:	US
Telephone Number	:	303-788-7440
Fax Number	:	303-788-4633

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	05/26/2010

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