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
Fax: (501) 778-7360
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528027828 NPPES
Arkansas MEDICAID 105298001
Arkansas Other 5473014
Arkansas Other 11140000

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