Burgess, Roxanne L

Burgess, Roxanne L is an sole proprietor health care provider with primary practice located at 11030 S Tryon St Ste 308, Charlotte NC 28273-6545. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is her primary health care specialty. Burgess, Roxanne L can be contacted via phone (704) 504-1004.

Contact Information

Primary practice address
11030 S Tryon St Ste 308 Charlotte NC 28273-6545
Phone: (704) 504-1004
Fax: (704) 504-0007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X NC461 North Carolina
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X NC461 North Carolina

Profile Details

NPI number 1457533473
LBN Legal business name Burgess, Roxanne L
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2007
Last updated Feb 18th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457533473 NPPES
North Carolina Other 5564660001 CIGNA GOVERNMENT SERVICES
North Carolina MEDICAID 89081AV CIGNA GOVERNMENT SERVICES
North Carolina MEDICAID NPD461 CIGNA GOVERNMENT SERVICES
North Carolina Other 081AV CIGNA GOVERNMENT SERVICES

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