Individual
DR. JAMES BOOTH BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1202 LOUISIANA AVENUE, SHREVEPORT, LA 71101-3910
(318) 212-8780
(318) 212-6752
Mailing address
1202 LOUISIANA AVENUE, SHREVEPORT, LA 71101-3910
(318) 212-8780
(318) 212-6752
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
10891R
LA
208600000X
Surgery Physician
Primary
MD.10891R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020045711
RR MEDICARE NUMBER
LA
01
—
060852301
TEXAS MEDICAID NUMBER
TX
05
—
1493899
—
LA
Enumeration date
06/09/2005
Last updated
06/21/2021
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