Individual
GARY VON BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-4881
(318) 675-5069
Mailing address
1501 KINGS HWY, DEPARTMENT OF MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-4881
(318) 675-5069
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
07461R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1363731
—
LA
Enumeration date
07/21/2006
Last updated
04/07/2017
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