MEDICARE: DR. JAMES LOWELL BURKE D.C.

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	111N00000X	Chiropractor	CH6796	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1619061488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES LOWELL BURKE D.C.

Provider Business Mailing Address
First Line	:	3190 MARTIN LUTHER KING ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-2037
Country	:	US
Telephone Number	:	728-686-4852
Fax Number	:	727-894-3476

Provider Business Practice Location Address
First Line	:	3200 4TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-2127
Country	:	US
Telephone Number	:	727-823-3151
Fax Number	:	727-821-2419

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	06/13/2014

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