Organization
DR MARLON BURT OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLON G BURT OD (OWNER)
(610) 683-3888
Entity
Organization
Contact information
Practice address
126 W MAIN ST, KUTZTOWN, PA 19530-1712
(610) 683-3888
(610) 683-3083
Mailing address
PO BOX 268, KUTZTOWN, PA 19530-0268
(610) 683-3888
(610) 683-3083
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001552
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3000375
KHPC
—
01
—
50041187
CAPITOL BLUE
PA
01
—
MA1669529
BLUE SHIELD
PA
Enumeration date
11/04/2005
Last updated
10/29/2008
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