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RUSSELL R BURKEN MD

>> Dermatology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1508858200

Individual Registrant:
 RUSSELL R BURKEN MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
274 BIG A ROAD  TOCCOA, GA 30577-6002 US
Tel: 706-886-6069  Fax: 706-282-5299

Contact information for business:
274 BIG A ROAD  TOCCOA, GA 30577-6002 US
Tel: 706-886-6069  Fax: 706-282-5299

Registration Information:
NPI: 1508858200
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207N00000XAllopathic & Osteopathic Physicians
Dermatology
GA30438

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
000363932AGA05




HEALTH CARE JOBS GA - Page 1



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