Individual provider · NPI-1

Dr. Peter Arthur Burgos, M.D.

Family Medicine · Olathe, KS

NPI number1154767655
StatusActive
Last updated in NPPESMay 11, 2013

Details

NPI
1154767655
Entity type
Individual (NPI-1)
Name
Dr. Peter Arthur Burgos
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
May 11, 2013
Last updated
May 11, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine04-24246KSYes
207Q00000X Family Medicine04-21442OK
207Q00000X Family Medicine01066005AIN

Practice location

1337 S Fountain Dr
Olathe, KS 66061-7205

Phone 913-397-7800 · Fax 913-397-7801

Mailing address

11701 S 101st East Ave
Bixby, OK 74008-2230

Phone 918-417-0074

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