Individual
DR. KEITH ALLEN BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1608 MAIN ST, CONWAY, SC 29526-3572
(843) 248-4700
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
91294
SC
207Q00000X
Family Medicine Physician
S3642
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39737373
—
NM
05
—
405651701
—
TX
01
—
884228
MEDICARE
TX
01
—
8LU873
BCBS
TX
05
—
912944
—
SC
01
—
SCS3549443
MEDICARE
SC
Enumeration date
03/22/2016
Last updated
07/05/2024
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