Burnham, Jeffrey Mark
Burnham, Jeffrey Mark is an individual health care provider with primary practice located at 10310 The Grove Blvd Ste 100 , Baton Rouge LA 70836-6455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Burnham, Jeffrey Mark can be contacted via phone (225) 761-5200.Contact Information
Primary practice address
10310 The Grove Blvd Ste 100
Baton Rouge LA 70836-6455
Phone: (225) 761-5200
Fax: (225) 761-5702
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 017109 | Louisiana |
Profile Details
| NPI number | 1295729481 |
|---|---|
| LBN Legal business name | Burnham, Jeffrey Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 2nd, 2005 |
| Last updated | Mar 30th, 2021 - 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 | 1295729481 | NPPES |
| Louisiana | MEDICAID | 1357502 | |
| Louisiana | Other | 080179868 |
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