Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 19139 | MS |
NPI | 1033115597 |
---|---|
Provider Name | Jeffrey A Burns |
First Address | Hattiesburg, MS 39402-1331 |
Second Address | Hattiesburg, MS 39402-1331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 12/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00175800 | (05) | MS |
1418188 | (05) | LA |
3495672 | AMERICAN ADMIN GROUP (01) | MS |
I13802 | (02) | |
P00308316 | RAILROAD MEDICARE (01) | MS |