1235198516 NPI number — WILLIAM N BURNS MD

Table of content: WILLIAM N BURNS MD (NPI 1235198516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235198516 NPI number — WILLIAM N BURNS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURNS
Provider First Name:
WILLIAM
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235198516
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1600 MEDICAL CENTER DR
Provider Second Line Business Mailing Address:
SUITE 4500
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-3656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-691-1400
Provider Business Mailing Address Fax Number:
304-691-1453

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 4500
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-3656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-691-1400
Provider Business Practice Location Address Fax Number:
304-691-1453
Provider Enumeration Date:
03/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  20002 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VE0102X , with the licence number: 20002 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2176854 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64066442 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6200121000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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