Dr. Jeffrey Mark Burnham
Family Doctor - Sports Medicine
10310 The Grove Blvd Ste 100
Baton Rouge
, Louisiana 70836-6455
Dr. Jeffrey Mark Burnham
Family Doctor - Sports Medicine
10310 The Grove Blvd Ste 100
Baton Rouge
, Louisiana 70836-6455
(225) 237-1786
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Jeffrey Mark Burnham
- 12916 Morgan Meadow Avenue
- Baton Rouge, LA
- Zip : 70818
- Fax : (225) 237-1786
- Phone : (225) 938-9287
Second Address
- Dr. Jeffrey Mark Burnham
- 10310 The Grove Blvd Ste 100
- Baton Rouge, LA
- Zip : 70836-6455
- Fax : (225) 761-5702
- Phone : (225) 761-5200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 017109 | LA |
National Provider Identifier
| NPI | 1295729481 |
|---|---|
| Provider Name | Dr. Jeffrey Mark Burnham |
| First Address | Baton Rouge, LA 70818 |
| Second Address | Baton Rouge, LA 70836-6455 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/09/2005 |
| Last Update Date | 30/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 080179868 | RAILROAD MEDICARE (01) | LA |
| 1357502 | (05) | LA |
| B63211 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.