Provider Demographics
NPI:1013199215
Name:DANIEL M. BURCHFIELD, M.D.,PHD
Entity Type:Organization
Organization Name:DANIEL M. BURCHFIELD, M.D.,PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BURCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PHD
Authorized Official - Phone:928-778-9250
Mailing Address - Street 1:3655 CROSSINGS DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7101
Mailing Address - Country:US
Mailing Address - Phone:928-778-9250
Mailing Address - Fax:928-778-2306
Practice Address - Street 1:3655 CROSSINGS DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7101
Practice Address - Country:US
Practice Address - Phone:928-778-9250
Practice Address - Fax:928-778-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26158174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ407959Medicaid
AZ200033429OtherRAILROAD MEDICARE
AZF35504Medicare UPIN
AZ407959Medicaid