Healthcare Provider Details

I. General information

NPI: 1841230844
Provider Name (Legal Business Name): JOHN SPOTSWOOD BURWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 HIGHWAY DR
OXFORD AL
36203-1951
US

IV. Provider business mailing address

PO BOX 93
LANDISVILLE PA
17538-0093
US

V. Phone/Fax

Practice location:
  • Phone: 256-241-2230
  • Fax: 256-241-2235
Mailing address:
  • Phone: 800-800-1617
  • Fax: 866-759-5426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number14175
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: