Individual
RUSSELL R BURKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
274 BIG A ROAD, TOCCOA, GA 30577-6002
(706) 886-6069
(706) 282-5299
Mailing address
274 BIG A ROAD, TOCCOA, GA 30577-6002
(706) 886-6069
(706) 282-5299
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
30438
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000363932A
—
GA
Enumeration date
08/18/2005
Last updated
06/25/2015
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