Doctor Name: | DR. EMILY JANE BURGOON |
NPI Number: | 1174870174 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 2010021895 |
Business Practice Address: | 45 Castle Rock Rd 2a Sedona, AZ - 863518806 |
Business Phone Number: | 5407985655 |
Business Fax Number: | |
Mailing Address: | 45 Castle Rock Rd 2a, SEDONA |
State: | AZ |
Postal Code: | 863518806 |
Phone Number: | 5407985655 |
Fax Number: | 9288520041 |
NPI Enumeration Date: | 08/08/2012 |
NPI Last Update Date: | 11/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 2010021895 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |