Basic Information
| Provider Information | |||||||||
| NPI: | 1962693796 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURROW | ||||||||
| FirstName: | REX | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8066 WALNUT RUN RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | CORDOVA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380188842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012523411 | ||||||||
| FaxNumber: | 9017634305 | ||||||||
| Practice Location | |||||||||
| Address1: | 305 RAWLS DR | ||||||||
| Address2: | |||||||||
| City: | MCCOMB | ||||||||
| State: | MS | ||||||||
| PostalCode: | 396482833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016840465 | ||||||||
| FaxNumber: | 6016843031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2007 | ||||||||
| LastUpdateDate: | 09/17/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0105X | 51249 | TN | N | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine | 207ZP0102X | 04964 | MS | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.