Healthcare Provider Details

I. General information

NPI: 1720033723
Provider Name (Legal Business Name): DAVID W BURKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID WALTER BURKS

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100236
GAINESVILLE FL
32610-0236
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-0034
  • Fax: 352-374-6153
Mailing address:
  • Phone: 352-273-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME60652
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME80652
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberME80652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: