Kelly Douglas Burchett
Otolaryngology/Facial Plastic Surgery
1605 South Baltomore Suite B
Kirksville
, Missouri 63501
Kelly Douglas Burchett
Otolaryngology/Facial Plastic Surgery
1605 South Baltomore Suite B
Kirksville
, Missouri 63501
(660) 665-3570
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About
Features
Specialties
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Kelly Douglas Burchett
- 1605 South Baltimore Suite B
- Kirksville, MO
- Zip : 63501
- Fax : (660) 665-3570
- Phone : (660) 665-3599
Second Address
- Kelly Douglas Burchett
- 1605 South Baltomore Suite B
- Kirksville, MO
- Zip : 63501
- Fax : (660) 665-3570
- Phone : (660) 665-3599
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 2001010344 | MO |
National Provider Identifier
| NPI | 1629161864 |
|---|---|
| Provider Name | Kelly Douglas Burchett |
| First Address | Kirksville, MO 63501 |
| Second Address | Kirksville, MO 63501 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/10/2006 |
| Last Update Date | 09/09/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 207392200 | (05) | MO |
| H52272 | (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.