Provider Demographics
NPI:1265626840
Name:BURROW, JOSHUA W (PA)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:W
Last Name:BURROW
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:2121 E HARMONY RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3400
Mailing Address - Country:US
Mailing Address - Phone:970-482-3328
Mailing Address - Fax:970-482-1433
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:SUITE 160
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-482-3328
Practice Address - Fax:970-482-1433
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2017-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS15--01235363A00000X
COPA.0004892363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49262505Medicaid
KS200461130HMedicaid
CO550851YLB8Medicare PIN
KS200461130HMedicaid