Provider Demographics
NPI:1083046940
Name:BURKE ANESTHESIA CONSULTANTS
Entity Type:Organization
Organization Name:BURKE ANESTHESIA CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-808-5983
Mailing Address - Street 1:3281 S HIGHLAND DR
Mailing Address - Street 2:SUITE 807
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-5404
Mailing Address - Country:US
Mailing Address - Phone:702-376-5084
Mailing Address - Fax:
Practice Address - Street 1:3281 S HIGHLAND DR
Practice Address - Street 2:SUITE 807
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-5404
Practice Address - Country:US
Practice Address - Phone:702-376-5084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9779207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty