Provider Demographics
NPI:1740393958
Name:BURNELL, ARLINE H (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLINE
Middle Name:H
Last Name:BURNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8122
Mailing Address - Country:US
Mailing Address - Phone:970-243-0900
Mailing Address - Fax:970-245-4235
Practice Address - Street 1:1001 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8122
Practice Address - Country:US
Practice Address - Phone:970-243-0900
Practice Address - Fax:970-245-4235
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31407208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01314079Medicaid
COJ0058Medicare ID - Type Unspecified
CO01314079Medicaid