Individual
BRENT ALEXANDER BURKET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2828 E BARNETT RD, MEDFORD, OR 97504-8342
(541) 789-8000
(541) 789-8225
Mailing address
2825 E BARNETT RD, MSS, MEDFORD, OR 97504-8332
(541) 789-4281
(541) 789-4506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G84835
CA
207Q00000X
Family Medicine Physician
Primary
MD24036
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022868
—
OR
05
—
1720048168
—
OR
01
—
943096772
FEDERAL TAX ID
—
Enumeration date
03/27/2006
Last updated
12/19/2023
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