Burkhart, Susan Mary
Burkhart, Susan Mary is an individual health care provider with primary practice located at 801 Kidwell Drive St Mary'S Clinic, Versailles MO 65084. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Burkhart, Susan Mary can be contacted via phone (573) 378-5454.Contact Information
Primary practice address
801 Kidwell Drive St Mary'S Clinic
Versailles MO 65084
Phone: (573) 378-5454
Fax: (573) 378-5055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 104938 | Missouri |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 104938 | Missouri |
Profile Details
| NPI number | 1447257571 |
|---|---|
| LBN Legal business name | Burkhart, Susan Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2005 |
| Last updated | Sep 28th, 2012 - about 13 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 | 1447257571 | NPPES |
| Missouri | Other | 33968017 | BCBS |
| Missouri | MEDICAID | 207903022 | BCBS |
| Missouri | MEDICAID | 2007903022 | BCBS |
| Missouri | Other | 853019 | BCBS |
| Missouri | Other | 32329 | BCBS |
| Missouri | Other | 5487 | BCBS |
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