Provider Demographics
NPI:1992818140
Name:BURLEW, CLAY COTHREN (MD)
Entity type:Individual
Prefix:
First Name:CLAY
Middle Name:COTHREN
Last Name:BURLEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:C
Other - Last Name:COTHREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:777 BANNOCK STREET
Mailing Address - Street 2:MC 7782 DENVER HEALTH 7 HOSPITAL AUTHORITY
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4507
Mailing Address - Country:US
Mailing Address - Phone:303-436-6559
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK STREET
Practice Address - Street 2:DENVER HEALTH & HOSPITAL AUTHORITY
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40086208600000X
CODR.00400862086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO71428020Medicaid
CO71428020Medicaid
H72877Medicare UPIN