Organization
BRUCE K BURTON MD PA
Active
Organization
BRUCE K BURTON MD PA
Active
Other names
Malvern Diagnostic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE KENT BURTON MD (PRESIDENT OWNER)
(501) 337-9031
Entity
Organization
Contact information
Practice address
2223 GRANT STREET, MALVERN, AR 72104
(501) 337-9031
(501) 337-9033
Mailing address
2223 GRANT STREET, MALVERN, AR 72104
(501) 337-9031
(501) 337-9033
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MC 0784
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110030002
—
AR
01
—
57801
BCBS
AR
Enumeration date
10/05/2006
Last updated
11/18/2009
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