Basic Information
Provider Information
NPI: 1548604838
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURLON
FirstName: DREW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
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Mailing Information
Address1: 2695 ROCKY MOUNTAIN AVE STE 150
Address2:  
City: LOVELAND
State: CO
PostalCode: 805389071
CountryCode: US
TelephoneNumber: 9706242403
FaxNumber: 9704904173
Practice Location
Address1: 1400 E BOULDER ST
Address2:  
City: COLORADO SPRINGS
State: CO
PostalCode: 809095533
CountryCode: US
TelephoneNumber: 7193651292
FaxNumber: 7193656997
Other Information
ProviderEnumerationDate: 04/17/2013
LastUpdateDate: 08/08/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XIP1408KYN Allopathic & Osteopathic PhysiciansInternal Medicine 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000XDR.0056764COY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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