Provider Demographics
NPI:1609800770
Name:BURROUGHS, JAMES D (DC, APRN C-NP)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:BURROUGHS
Suffix:
Gender:M
Credentials:DC, APRN C-NP
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:BURROUGHS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, APRN C-NP
Mailing Address - Street 1:2401 KINGSLEY LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73128-4924
Mailing Address - Country:US
Mailing Address - Phone:405-921-5005
Mailing Address - Fax:
Practice Address - Street 1:3209 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4131
Practice Address - Country:US
Practice Address - Phone:405-842-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3565111N00000X
TX987323363LF0000X
OKR98434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U91797Medicare UPIN