Burken, Russell R
Burken, Russell R is an individual health care provider with primary practice located at 274 Big A Road , Toccoa GA 30577-6002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Burken, Russell R can be contacted via phone (706) 886-6069.Contact Information
Primary practice address
274 Big A Road
Toccoa GA 30577-6002
Phone: (706) 886-6069
Fax: (706) 282-5299
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 30438 | Georgia |
Profile Details
| NPI number | 1508858200 |
|---|---|
| LBN Legal business name | Burken, Russell R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Jun 25th, 2015 - about 9 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 | 1508858200 | NPPES |
| Georgia | MEDICAID | 000363932A |
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