Individual
DR. TODD S BURRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST, SUITE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01055481A
IN
208600000X
Surgery Physician
40328
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221511
ANTHEM BLUE CROSS/SHIELD
IN
01
—
01055481
INDIANA STATE LICENSE
IN
05
—
200356290
—
IN
01
—
40328
KENTUCKY STATE LICENSE
KY
05
—
64049620
—
KY
Enumeration date
07/21/2005
Last updated
07/01/2024
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