Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 03417R | LA |
NPI | 1013930957 |
---|---|
Provider Name | Richard Frank Burroughs |
First Address | New Orleans, LA 70112-1221 |
Second Address | Baton Rouge, LA 70805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1138312 | (05) | LA |
B61415 | (02) |