Organization
BURTON MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI LUKE (OFFICE MANAGER)
(229) 391-3577
Entity
Organization
Contact information
Practice address
39 KENT RD, 1, TIFTON, GA 31794-1649
(229) 391-3577
Mailing address
39 KENT RD, 1, TIFTON, GA 31794-1649
(229) 391-3577
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
031888
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000398593E
—
GA
Enumeration date
03/21/2007
Last updated
10/31/2008
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