Individual
ELLIOTT BOYD BURDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 475-3398
Mailing address
1060 MELISSA DR, WATKINSVILLE, GA 30677-4113
(706) 436-4692
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
82847
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
04/01/2015
Last updated
06/15/2020
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