Individual provider · Type 1 NPI

Larry Avis Bourg, MD

Specialist · Parker, CO

NPI number 1205800182 Active

Practice location

12230 Lioness Way
Parker, CO 80134-5603

Call (720) 644-9355 Map

Mailing address

9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X39560 (CO)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1205800182

Larry Avis Bourg, MD's National Provider Identifier is 1205800182, issued on Feb 15, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Parker, CO. The record was last updated on Aug 8, 2023.