Organization
DERMATOLOGY CENTER OF NORTH MS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D BURK MD (PRESIDENT)
(662) 844-6272
Entity
Organization
Contact information
Practice address
516 PEGRAM DR, TUPELO, MS 38801-6347
(662) 844-6272
(662) 844-1603
Mailing address
516 PEGRAM DR, TUPELO, MS 38801-6347
(662) 844-6272
(662) 844-1603
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
7919
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9015434
—
MS
Enumeration date
10/17/2006
Last updated
03/26/2015
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