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Individual

DR. JEREMY A, BURD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4400 BROADWAY ST, SUITE 407, KANSAS CITY, MO 64111-3498
(816) 932-1711
(816) 932-1719
Mailing address
PO BOX 504407, SAINT LOUIS, MO 63150-4407
(816) 932-7940
(816) 932-7957

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
04-26995
KS
2084P0800X
Psychiatry Physician
Primary
2005004431
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207395500
MO
Enumeration date
08/31/2006
Last updated
03/07/2012
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