Individual
MRS. MARY BURGESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
407 E 22ND ST, HUNTINGBURG, IN 47542-8964
(812) 683-3612
(812) 683-2819
Mailing address
PO BOX 1028, JASPER, IN 47547-1028
(812) 996-5255
(812) 996-8497
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01028935
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100325260
—
IN
Enumeration date
04/04/2006
Last updated
02/03/2016
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