Individual
DR. JOHN M. BURSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2115 S FREMONT AVE, SUITE 2900, SPRINGFIELD, MO 65804-2239
(417) 820-3535
(417) 820-3540
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
119369
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150465001
—
AR
05
—
204647010
—
MO
01
—
98570
AR BLUE SHIELD #
MO
Enumeration date
02/12/2007
Last updated
10/02/2014
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