Burgess, Matthew Evan

Burgess, Matthew Evan is an individual health care provider with primary practice located at 2855 Main Ave Ste A103, Durango CO 81301-5956. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Burgess, Matthew Evan can be contacted via phone (970) 382-8970.

Contact Information

Primary practice address
2855 Main Ave Ste A103 Durango CO 81301-5956
Fax: (970) 382-8966
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2950 Colorado
Eye and Vision Services Providers / Optometrist 152W00000X 628 New Mexico

Profile Details

NPI number 1477702835
LBN Legal business name Burgess, Matthew Evan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 10th, 2008
Last updated May 2nd, 2013 - 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 1477702835 NPPES
New Mexico MEDICAID 87787857

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