Healthcare Provider Details

I. General information

NPI: 1982536280
Provider Name (Legal Business Name): REESE BOYD BURKHARDT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 7TH AVE S
BIRMINGHAM AL
35233-2005
US

IV. Provider business mailing address

300 ACADEMY DR
ANDALUSIA AL
36420-4141
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3387
  • Fax:
Mailing address:
  • Phone: 334-343-1218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000X
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: