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Contact Information

SCOTT D BURGNER
1108 E HISTORIC HIGHWAY 66
GALLUP, NM87301-5466
 Phone: 505-726-9642
 Fax: 505-726-9642
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Health Worker

172V00000X
Indicates primary specialty

NPI Profile & details for SCOTT D BURGNER · (Male)

NPI Number 1952152514
Status Active
Credentials
Entity Individual
Enumeration date 04/01/2024
Last updated 10/14/2025 - About 8 months ago
Sole proprietor 1 No
Identifiers
  • AZ License # CHW0000000656
  • NM License # 32D2133123
  • NM License # G-1774
  • NM Medicaid N0035451
  • Other 1073138244 GROUP NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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