Burson, Mark Lloyd

Burson, Mark Lloyd is an sole proprietor health care provider with primary practice located at 107 Ledford Mill Rd , Tullahoma TN 37388-2278. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Burson, Mark Lloyd can be contacted via phone (931) 454-1955.

Contact Information

Primary practice address
107 Ledford Mill Rd Tullahoma TN 37388-2278
Phone: (931) 454-1955
Fax: (931) 454-1956
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 0101265824 Virginia
Allopathic & Osteopathic Physicians / Urology 208800000X 40439 Tennessee

Profile Details

NPI number 1104808229
LBN Legal business name Burson, Mark Lloyd
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2005
Last updated Mar 5th, 2019 - about 5 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1104808229 NPPES
Tennessee Other 4116328 BCBS

Popular Providers