Healthcare Provider Details

I. General information

NPI: 1225056815
Provider Name (Legal Business Name): ASHLEY KEIR BURCHFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8371 HIGHWAY 72 W SUITE 100
MADISON AL
35758-9505
US

IV. Provider business mailing address

PO BOX 2705
HUNTSVILLE AL
35804-2705
US

V. Phone/Fax

Practice location:
  • Phone: 256-726-6970
  • Fax: 256-726-6971
Mailing address:
  • Phone: 256-265-7791
  • Fax: 256-265-7767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00022770
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: