Individual
MARY T. BURKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-6901
(502) 852-6056
Mailing address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-6901
(502) 852-6056
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28806
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050070901
RR MEDICARE
KY
05
—
64288061
—
KY
Enumeration date
06/08/2006
Last updated
05/05/2008
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