Basic Information
Provider Information
NPI: 1619191863
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURROWS
FirstName: DARYL
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 21850
Address2:  
City: HOT SPRINGS
State: AR
PostalCode: 719031850
CountryCode: US
TelephoneNumber: 5016239581
FaxNumber: 5016231523
Practice Location
Address1: 1662 HIGDON FERRY RD
Address2: SUITE 230
City: HOT SPRINGS
State: AR
PostalCode: 719136912
CountryCode: US
TelephoneNumber: 5016239581
FaxNumber: 6016231523
Other Information
ProviderEnumerationDate: 04/12/2007
LastUpdateDate: 04/23/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101XE-5628ARY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

ID Information
IDTypeStateIssuerDescription
18357500105AR MEDICAID


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