Individual
MARILYN ANN BURSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
731 LEIGHTON AVE, ANNISTON, AL 36207-5761
(256) 235-5688
(256) 235-5590
Mailing address
PO BOX 2391, ANNISTON, AL 36202-2391
(256) 235-5688
(286) 235-5590
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11334
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13949
—
AL
01
—
4013373
BCBS OF TENN
TN
01
—
51013949
BCBS
AL
Enumeration date
09/27/2005
Last updated
07/08/2007
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