Individual
PHILLIP NEIL BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
203 12TH AVE RD, SUITE A, NAMPA, ID 83686-5012
(208) 466-3338
(208) 466-3554
Mailing address
2000 COUNTY LINE RD, EMMETT, ID 83617-9721
(208) 278-3031
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P-99
ID
213ES0131X
Foot Surgery Podiatrist
P-99
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015689
REGENCE BLUE SHIELD
ID
05
—
001519600
—
ID
01
—
480033019
RAILROAD MEDICARE
ID
01
—
P2446
BLUE CROSS OF IDAHO
ID
Enumeration date
10/13/2005
Last updated
12/05/2008
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