Burton, Charles Russell
Burton, Charles Russell is an individual health care provider with primary practice located at 819 W Carpenter St , Benton AR 72015-3349. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Burton, Charles Russell can be contacted via phone (501) 778-8264.Contact Information
Primary practice address
819 W Carpenter St
Benton AR 72015-3349
Phone: (501) 778-8264
Fax: (501) 778-7360
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C-6384 | Arkansas |
Profile Details
NPI number | 1528027828 |
---|---|
LBN Legal business name | Burton, Charles Russell |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 23rd, 2006 |
Last updated | May 19th, 2008 - about 17 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 | 1528027828 | NPPES |
Arkansas | MEDICAID | 105298001 | |
Arkansas | Other | 5473014 | |
Arkansas | Other | 11140000 |
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