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Individual

OMER L BURNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 934-5038
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
26939
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02858317
MS
01
051598253
BCBS
AL
01
051598254
BCBS
AL
01
051598255
BCBS
AL
01
051598256
BCBS
AL
01
051598257
BCBS
AL
01
051598258
BCBS
AL
05
110247
AL
05
110252
AL
05
110254
AL
05
110256
AL
05
110257
AL
05
110258
AL
01
P00821378
RAILROAD MEDICARE
AL
Enumeration date
05/22/2007
Last updated
09/22/2011
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