MEDICARE: GARY D BURTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	35052932	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	820000032	OTHER		TRAVELERS MEDICARE
6	0622792	OTHER		PALMETTO MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	311098079	OTHER	PPO NEXT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0800039	OTHER	UHC
5	647544	OTHER	AETNA
7	311098079030	OTHER	CIGNA

General Provider Information

NPI Number	:	1053369207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY D BURTON MD

Provider Business Mailing Address
First Line	:	L-3652
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43260-0001
Country	:	US
Telephone Number	:	740-383-7927
Fax Number	:	740-383-7942

Provider Business Practice Location Address
First Line	:	1040 DELAWARE AVENUE
Second Line	:
City	:	MARION
State	:	OH
Zip	:	43301-1814
Country	:	US
Telephone Number	:	740-383-8050
Fax Number	:	740-383-7084

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	06/16/2018

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Directions to “ GARY D BURTON MD” Practice Location

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