Individual
MARK LLOYD BURSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0101265824
VA
208800000X
Urology Physician
Primary
36112
GA
208800000X
Urology Physician
40439
TN
208800000X
Urology Physician
CDR.0004667
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4116328
BCBS
TN
Enumeration date
11/15/2005
Last updated
06/19/2025
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