Provider Demographics
NPI:1477506913
Name:BURROWS, JAMES DOUGLAS (MD, FRCS (C))
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:BURROWS
Suffix:
Gender:M
Credentials:MD, FRCS (C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4052 PIONEER PKWY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-2062
Mailing Address - Country:US
Mailing Address - Phone:801-966-3977
Mailing Address - Fax:801-966-4043
Practice Address - Street 1:4052 PIONEER PKWY
Practice Address - Street 2:SUITE 208
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-2062
Practice Address - Country:US
Practice Address - Phone:801-966-3977
Practice Address - Fax:801-966-4043
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2749521205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1186960001OtherCIGNA-DMERC ID#
UTF45380Medicare UPIN