Healthcare Provider Details

I. General information

NPI: 1336486885
Provider Name (Legal Business Name): JOHN JOSEPH BURNS III PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 HODGSON MEMORIAL DR
SAVANNAH GA
31406-2549
US

IV. Provider business mailing address

7001 HODGSON MEMORIAL DR
SAVANNAH GA
31406-2549
US

V. Phone/Fax

Practice location:
  • Phone: 912-355-1437
  • Fax:
Mailing address:
  • Phone: 912-355-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number003081
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: