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Individual

JOHN R BURNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
914B MAR WALT DR, FORT WALTON BEACH, FL 32547-6706
(850) 226-6572
(850) 862-8564
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
9309
AL
208800000X
Urology Physician
Primary
ME112897
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000005985
BLUE CROSS
AL
05
000005985
AL
01
05620202
MISSISSIPPI MEDICAID
MS
01
0858508
CIGNA
FL
01
1192950
WELLCARE
FL
01
14SM4
BCBS OF FL
FL
01
408113124
RAILROAD MEDICARE
AL
01
4736816
AETNA
FL
01
592-22320
BCBS AL
AL
01
C76422
VIVA
AL
01
P01255861
RAILROAD MCR
FL
Enumeration date
06/08/2006
Last updated
04/25/2016
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