Provider Demographics
NPI:1265904510
Name:BURKHARDT, JUSTIN (PA-C)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:BURKHARDT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:750 W HAMPDEN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2167
Mailing Address - Country:US
Mailing Address - Phone:508-213-1947
Mailing Address - Fax:
Practice Address - Street 1:6080 W 92ND AVE STE 1000
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2935
Practice Address - Country:US
Practice Address - Phone:303-427-0796
Practice Address - Fax:303-429-9399
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2022-04-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant