Provider Demographics
NPI:1053304089
Name:BURRELL, KIM (DO)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:
Last Name:BURRELL
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Gender:F
Credentials:DO
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Mailing Address - Street 1:15901 E BRIARWOOD CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1599
Mailing Address - Country:US
Mailing Address - Phone:303-699-3107
Mailing Address - Fax:303-699-3170
Practice Address - Street 1:15901 E BRIARWOOD CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1599
Practice Address - Country:US
Practice Address - Phone:303-699-3107
Practice Address - Fax:303-699-3170
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2020-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO33900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF95431Medicare UPIN
COCN3118Medicare PIN