Burket, Brent Alexander
Burket, Brent Alexander is an individual health care provider with primary practice located at 2828 E Barnett Rd , Medford OR 97504-8342. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Burket, Brent Alexander can be contacted via phone (541) 789-8000.Contact Information
Primary practice address
2828 E Barnett Rd
Medford OR 97504-8342
Phone: (541) 789-8000
Fax: (541) 789-8225
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD24036 | Oregon |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | G84835 | California |
Profile Details
| NPI number | 1720048168 |
|---|---|
| LBN Legal business name | Burket, Brent Alexander |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 27th, 2006 |
| Last updated | Dec 19th, 2023 - about 2 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 | 1720048168 | NPPES |
| Oregon | MEDICAID | 1720048168 | |
| Oregon | Other | 943096772 | |
| Oregon | MEDICAID | 022868 |
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