Individual
MARK L BURTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
294 CHUBBY LANE, STE 2, COLUMBUS, MS 39705-2016
(662) 327-2574
(662) 327-2576
Mailing address
294 CHUBBY DR, SUITE2, COLUMBUS, MS 39705-1358
(662) 327-2574
(662) 327-2576
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18110
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07355897
—
MS
Enumeration date
03/01/2006
Last updated
02/03/2011
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