Burgoyne, Laura L

Burgoyne, Laura L is an individual health care provider with primary practice located at 262 Danny Thomas Place, Ms 0515 C/O Dana Cannon, Memphis TN 38105-3678. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Burgoyne, Laura L can be contacted via phone (901) 595-3006.

Contact Information

Primary practice address
262 Danny Thomas Place, Ms 0515 C/O Dana Cannon Memphis TN 38105-3678
Phone: (901) 595-3006
Fax: (901) 595-3842
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 39502 Tennessee

Profile Details

NPI number 1417953142
LBN Legal business name Burgoyne, Laura L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Apr 5th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417953142 NPPES
Alabama MEDICAID 009931936
Alabama MEDICAID 200378350A
Alabama MEDICAID 200529130A
Alabama MEDICAID 158595001
Alabama MEDICAID 177498601
Alabama MEDICAID 5440585
Alabama MEDICAID 06126056
Alabama MEDICAID 200058900A
Alabama MEDICAID 207369208
Alabama MEDICAID 64101025

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