Burgess, Kristian Derek
Burgess, Kristian Derek is an individual health care provider with primary practice located at 786 W Pioneer Blvd Ste A , Mesquite NV 89027-8862. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Burgess, Kristian Derek can be contacted via phone (702) 345-5000.Contact Information
Primary practice address
786 W Pioneer Blvd Ste A
Mesquite NV 89027-8862
Phone: (702) 345-5000
Fax: (702) 345-2000
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OT018627 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO2931 | Nevada |
Profile Details
| NPI number | 1457844292 |
|---|---|
| LBN Legal business name | Burgess, Kristian Derek |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2018 |
| Last updated | Oct 17th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457844292 | NPPES |
| Nevada | MEDICAID | 1457844292 | |
| Nevada | MEDICAID | OT018627 | |
| Nevada | Other | DO2931 |
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