Individual
DR. ENID F BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
87 MURRAY GUARD DR STE B, JACKSON, TN 38305-3775
(731) 422-0213
(731) 660-8319
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 422-0213
(731) 660-8319
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME0072841
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002497300
—
FL
01
—
070013233
RAILROAD MEDICARE
FL
01
—
2299671
GHI
FL
01
—
41326
BLUE CROSS BLUE SHIELD
FL
01
—
4404822
AETNA
FL
01
—
593536402 0011
CIGNA
FL
Enumeration date
12/28/2005
Last updated
01/25/2021
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