Individual
PATRICK THOMAS BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 JAMES SIMPSON JR WAY, STE 201, COVINGTON, KY 41011-0801
(859) 655-4111
(859) 655-4815
Mailing address
2300 CHAMBER CENTER DR, SUITE 300, LAKESIDE PARK, KY 41017-1686
(859) 655-4111
(859) 655-4814
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24790
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159140
MEDICAID
OH
05
—
64247901
—
KY
Enumeration date
03/23/2006
Last updated
11/11/2015
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