Provider Demographics
NPI:1609876523
Name:BURROWS, PETER J (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:BURROWS
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 1:850 N KOLB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1333
Mailing Address - Country:US
Mailing Address - Phone:520-731-0600
Mailing Address - Fax:520-731-2742
Practice Address - Street 1:850 N KOLB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1333
Practice Address - Country:US
Practice Address - Phone:520-731-0600
Practice Address - Fax:520-731-2742
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30452208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H63812Medicare UPIN
AZZ70683Medicare ID - Type Unspecified