Individual
DR. WILLIAM D. BURLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1732 MEDICAL PARK DR, BILOXI, MS 39532-2131
(228) 314-2510
(228) 314-2517
Mailing address
1732 MEDICAL PARK DR, BILOXI, MS 39532-2131
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
J1203
TX
2085R0001X
Radiation Oncology Physician
Primary
MS19362
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000190059
BLUE CROSS
MS
05
—
02007574
—
MS
01
—
09014182
MEDICAID GROUP #
MS
01
—
1033557-03
CSHCN
TX
05
—
1033557-03
—
TX
01
—
8P2376
BLUE SHIELD
TX
01
—
C00047
MEDICARE GROUP #
MS
01
—
P00219726
RR/MEDICARE
TX
Enumeration date
04/05/2006
Last updated
10/17/2013
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