Healthcare Provider Details

I. General information

NPI: 1497971667
Provider Name (Legal Business Name): JEFFREY K. BURNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SEYMOUR ST STE 100
HARTFORD CT
06106-5521
US

IV. Provider business mailing address

74 BATTERSON PARK RD STE 107
FARMINGTON CT
06032-2565
US

V. Phone/Fax

Practice location:
  • Phone: 860-549-8208
  • Fax:
Mailing address:
  • Phone: 860-549-3210
  • Fax: 860-247-3803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number046417
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number036118111
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number046417
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: