Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 19574 | TN |
NPI | 1174508808 |
---|---|
Provider Name | Dr. Edward Brantley Burns JR. |
First Address | Knoxville, TN 37930-2569 |
Second Address | Knoxville, TN 37916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C75332 | (02) | |
Q006040 | (05) | TN |