Provider Demographics
NPI:1467615542
Name:BURROW, DENNIS R (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:R
Last Name:BURROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5543
Mailing Address - Country:US
Mailing Address - Phone:501-227-8439
Mailing Address - Fax:
Practice Address - Street 1:311 N ELM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5543
Practice Address - Country:US
Practice Address - Phone:501-227-8439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-5378207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR50799OtherBCBS
AR104775001Medicaid
AR5H387Medicare PIN
C67922Medicare UPIN
AR50799Medicare PIN