Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 19084 | KY |
NPI | 1013914381 |
---|---|
Provider Name | Dr. Eugene James Burchell JR. |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Covington, KY 41011-0801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 18/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64190846 | (05) | KY |
C64489 | (02) | KY |