Individual
JOHN KEVIN BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 LAKE AVENUE, VA NORTHERN INDIANA HEALTHCARE SYSTEM, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1383
Mailing address
2121 LAKE AVENUE, VA NORTHERN INDIANA HEALTHCARE SYSTEM, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1383
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01043507A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200059140
—
IN
Enumeration date
08/18/2005
Last updated
09/12/2021
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