Individual
JAMIE TIDMORE BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
840 W FLOYD BAKER BLVD, GAFFNEY, SC 29341-1845
(864) 489-3300
(864) 488-3744
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37703
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377032
—
SC
01
—
SCD6756067
MEDICARE PIN
SC
01
—
SCD6756121
MEDICARE PIN
SC
01
—
SCD675J577
MEDICARE PIN
SC
Enumeration date
05/28/2015
Last updated
03/30/2023
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