Provider Demographics
NPI:1194834168
Name:BURTON, DOUGLAS C (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:C
Last Name:BURTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP, MS 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-7816
Mailing Address - Country:US
Mailing Address - Phone:913-588-6100
Mailing Address - Fax:913-588-0862
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:ORTHOPEDIC SURGERY
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6100
Practice Address - Fax:913-588-0862
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-25888207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100369280AMedicaid
MO26997022OtherBCBS
KS380380OtherFIRSTGUARD
200039499OtherRAILROAD MEDICARE
MO205147200Medicaid
KS100369280AMedicaid
MO205147200Medicaid