Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 38093 | AL |
N | 207YS0123X | Facial Plastic Surgeon | 38093 | AL |
NPI | 1083034367 |
---|---|
Provider Name | Kent L. Burton |
First Address | Mobile, AL 36606-2457 |
Second Address | Mobile, AL 36606-2457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 16/06/2020 |