Allan Scott Burnside, M.D.

Individual provider Active NPI Family Medicine Physician · Dolores, CO

NPI 1942280573 · NPPES record last updated Jul 13, 2010

Key facts

NPI
1942280573
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
32885 (CO)
Practice address
507 Central Ave
Dolores, CO 81323
Phone
(970) 882-7221
Fax
(970) 882-7221
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32885COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dolores Medical Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32885 CO Yes

Addresses

Primary practice location

507 Central Ave
Dolores, CO 81323

Mailing address

PO Box 908
Dolores, CO 81323-0908
Phone (970) 882-7221

Other identifiers

IdentifierTypeStateIssuer
12635871OtherCORURAL HEALTH CLINIC
5502AMGR004393OtherCOANTHEM
01328855MedicaidCO
080053393OtherCORAILROAD MEDICARE

Other providers in Dolores, CO

All providers in Dolores, CO · Family Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.