Individual
MR. MICHAEL BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
19 MYRTLE ST, MEDFORD, OR 97504-7337
(541) 773-3863
(541) 776-2892
Mailing address
19 MYRTLE ST, MEDFORD, OR 97504-7337
(541) 773-3863
(541) 776-2892
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
23793
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201708072NP
OR
Other
Enumeration date
10/29/2013
Last updated
07/29/2021
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