Provider Demographics
NPI:1356566657
Name:AURORA INTERNAL MEDICINE CLINIC, PC
Entity type:Organization
Organization Name:AURORA INTERNAL MEDICINE CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-805-1800
Mailing Address - Street 1:13111 E BRIARWOOD AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3930
Mailing Address - Country:US
Mailing Address - Phone:303-805-1800
Mailing Address - Fax:303-805-9323
Practice Address - Street 1:13111 E BRIARWOOD AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3930
Practice Address - Country:US
Practice Address - Phone:303-810-6269
Practice Address - Fax:303-805-9323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
CO36303207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04021804Medicaid
COF3208Medicare PIN