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NPI Code Detail

MEDICARE: NATHAN DAVID BURROUGHS MD

MEDICARE: NATHAN DAVID BURROUGHS MD
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
1207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) PhysicianR5304MO
2207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) Physician0415409KS

Other Identifiers

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

General Provider Information

NPI Number : 1871579037
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN DAVID BURROUGHS MD
Provider Business Mailing Address
First Line : 9411 N OAK TRFY
Second Line : SUITE LL1
City : KANSAS CITY
State : MO
Zip : 64155-2262
Country : US
Telephone Number : 816-436-7072
Fax Number : 816-436-2743
Provider Business Practice Location Address
First Line : 9411 N OAK TRFY
Second Line : STE 202
City : KANSAS CITY
State : MO
Zip : 64155-2262
Country : US
Telephone Number : 816-468-8820
Fax Number : 816-468-8898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 02/08/2010

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Directions to “ NATHAN DAVID BURROUGHS MD” Practice Location

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