Burgess, Mary Joan
Burgess, Mary Joan is an individual health care provider with primary practice located at 4301 W Markham St # 783 , Little Rock AR 72205-7101. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is her primary health care specialty. Burgess, Mary Joan can be contacted via phone (501) 686-8000.Contact Information
Primary practice address
4301 W Markham St # 783
Little Rock AR 72205-7101
Phone: (501) 686-8000
Fax: (501) 526-5148
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | E-8677 | Arkansas |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | E-8677 | Arkansas |
Profile Details
| NPI number | 1407011968 |
|---|---|
| LBN Legal business name | Burgess, Mary Joan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2008 |
| Last updated | Aug 20th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407011968 | NPPES |
| Arkansas | MEDICAID | 204615001 | |
| Arkansas | Other | P00970254 |
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