NPI 1336110808 · live from the CMS NPI Registry
Jay Jeffrey Burlingame, O.D.
Optometrist in Overland Park, KS. National Provider Identifier 1336110808, active.
NPI record
| NPI | 1336110808 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 11500 W 119th St, Overland Park, KS 66213 |
| Practice phone | 913-451-0001 |
| Enumerated | January 31, 2006 |
| Last updated | February 9, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist, Corneal and Contact Management | 152WC0802X | 12753 (KS) |
| Optometrist, Pediatrics | 152WP0200X | 12753 (KS) |
| Optometrist primary | 152W00000X | 12753 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.