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Individual
PHILLIP NEIL BURK
Active
Individual
PHILLIP NEIL BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P-99
ID
213ES0131X
Foot Surgery Podiatrist
P-99
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015689
REGENCE BLUE SHIELD
ID
05
—
001519600
—
ID
01
—
480033019
RAILROAD MEDICARE
ID
01
—
P2446
BLUE CROSS OF IDAHO
ID
Enumeration date
10/13/2005
Last updated
12/05/2008
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