Individual
DR. STEPHEN MARCEL BURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1111 HIGHWAY 441 NORTH, PEARSON, GA 31642
(912) 422-7073
(912) 422-7019
Mailing address
P.O. BOX 425, 1111 HIGHWAY 441 NORTH, PEARSON, GA 31642
(912) 422-7073
(912) 422-7019
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
025727
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00272995E
—
GA
01
—
010062912
RAILROAD MEDICARE
GA
Enumeration date
09/14/2006
Last updated
10/19/2012
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