Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2911 | TN |
N | 208600000X | Surgeon | 2911 | TN |
N | 208200000X | Surgeon | 34-008439 | OH |
N | 208600000X | Surgeon | 34-008439 | OH |
Y | 2086S0127X | Trauma Surgeon | 2911 | TN |
N | 2086S0127X | Trauma Surgeon | 35-008439 | OH |
N | 2086S0127X | Trauma Surgeon | OS10105 | FL |
NPI | 1508821067 |
---|---|
Provider Name | Dr. James Bracken Burns JR. |
First Address | Johnson City, TN 37614 |
Second Address | Johnson City, TN 37614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1508821067 | (05) | VA |
2650448 | (05) | OH |
2784823-00 | (05) | FL |
428749571A | (05) | GA |
I52078 | (02) | OH |
Q016851 | (05) | TN |