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NPI Code Detail

MEDICARE: DR. JEFF PHILIP BURKE PT

MEDICARE: DR. JEFF PHILIP BURKE PT
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
1225100000XPhysical Therapist5501008037MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336141704
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFF PHILIP BURKE PT
Provider Business Mailing Address
First Line : 929 WEST ST
Second Line :
City : GAYLORD
State : MI
Zip : 49735-9309
Country : US
Telephone Number : 231-675-6920
Fax Number :
Provider Business Practice Location Address
First Line : 4045 W ROYAL DR
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-8965
Country : US
Telephone Number : 231-935-0901
Fax Number : 231-935-0308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 06/01/2012

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Directions to “ DR. JEFF PHILIP BURKE PT” Practice Location

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