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Individual

JOHN BURGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 629-7601
Mailing address
234 E GRAY ST, SUITE 850, LOUISVILLE, KY 40202-1900
(502) 585-1735

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25852
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000050040
BC BS
KY
01
000000308613
BC BS
KY
05
100357020A
IN
01
1052793
PASSPORT
KY
01
50005976
PASSPORT
KY
05
64258528
KY
Enumeration date
07/08/2005
Last updated
02/27/2008
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