Provider Demographics
NPI:1619025228
Name:BURROWS, CHRISTOPHER R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
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:PO BOX 1628
Mailing Address - Street 2:
Mailing Address - City:LAKE ISABELLA
Mailing Address - State:CA
Mailing Address - Zip Code:93240-1628
Mailing Address - Country:US
Mailing Address - Phone:760-379-2681
Mailing Address - Fax:760-379-2321
Practice Address - Street 1:6412 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:LAKE ISABELLA
Practice Address - State:CA
Practice Address - Zip Code:93240-9529
Practice Address - Country:US
Practice Address - Phone:760-379-2681
Practice Address - Fax:760-379-2321
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37888208D00000X
CAC145159207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0574319Medicaid
WI34071900Medicaid
WI34071900Medicaid
WI521330Medicare ID - Type Unspecified