Burruss, Valencia R
Burruss, Valencia R is an sole proprietor health care provider with primary practice located at 6126 Prestley Mill Rd Ste H , Douglasville GA 30134-5624. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Burruss, Valencia R can be contacted via phone (678) 715-2993.Contact Information
Primary practice address
6126 Prestley Mill Rd Ste H
Douglasville GA 30134-5624
Phone: (678) 715-2993
Fax: (678) 715-2827
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 041745 | Georgia |
Profile Details
NPI number | 1215972823 |
---|---|
LBN Legal business name | Burruss, Valencia R |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 18th, 2006 |
Last updated | Jun 25th, 2024 - about 3 months 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 | 1215972823 | NPPES |
Georgia | MEDICAID | 000752386D | |
Georgia | Other | 010606457 |
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