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Individual

SAMUEL TANNER BURKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
609 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 751-3722
(479) 751-1099
Mailing address
601 W MAPLE AVE STE 503, SPRINGDALE, AR 72764-5376
(479) 751-3722
(479) 751-1099

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R095402
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
121151
AR

Other

Enumeration date
04/17/2019
Last updated
11/12/2021
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