Individual
KEITH BURCHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9119 CINNAMON HL, SAN ANTONIO, TX 78240-5401
(210) 691-0737
Mailing address
322 SIMON, SAN ANTONIO, TX 78204-1750
(718) 974-6537
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036-138194
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
S9662
TX
2081P0004X
Spinal Cord Injury Medicine Physician
036-138194
IL
2081P0004X
Spinal Cord Injury Medicine Physician
S9662
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138194-1
—
IL
01
—
P01538726
RAILROAD MEDICARE
IL
Enumeration date
07/26/2010
Last updated
06/21/2021
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