Individual
DR. DENNIS BRENT BURKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4404 RED TAIL CT NW, ALBUQUERQUE, NM 87114-4129
(505) 899-1179
Mailing address
4404 RED TAIL CT NW, ALBUQUERQUE, NM 87114-4129
(505) 899-1179
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
88-132
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A028
TRICARE
NM
Enumeration date
05/24/2006
Last updated
09/07/2011
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