Organization
N KENT BURTON MEDICAL DIRECTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORRIS K BURTON (OWNER/PHYSICIAN)
(229) 392-8520
Entity
Organization
Contact information
Practice address
2401 RIDGE AVE N, TIFTON, GA 31794-2846
(229) 392-8520
(229) 391-3578
Mailing address
2401 RIDGE AVENUE NORTH, TIFTON, GA 31794
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
031888
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578558805
NPI
GA
Enumeration date
02/01/2013
Last updated
02/01/2013
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