MEDICARE: JESSICA WRIGHT BURGERT 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	207Q00000X	Family Medicine Physician	200301311	NC

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	:	1992811962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA WRIGHT BURGERT MD

Provider Business Mailing Address
First Line	:	205 PAGE RD
Second Line	:
City	:	PINEHURST
State	:	NC
Zip	:	28374-8749
Country	:	US
Telephone Number	:	910-295-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 GREENWAY CT
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-6954
Country	:	US
Telephone Number	:	919-292-1878
Fax Number	:	919-292-1879

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	01/23/2018

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