Healthcare Provider Details

I. General information

NPI: 1730150491
Provider Name (Legal Business Name): RICHARD L BURKEY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 FOREST AVE
GREAT BEND KS
67530-3607
US

IV. Provider business mailing address

3509 FOREST AVE
GREAT BEND KS
67530-3607
US

V. Phone/Fax

Practice location:
  • Phone: 620-793-7624
  • Fax: 620-793-5281
Mailing address:
  • Phone: 620-793-7624
  • Fax: 620-793-5281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number12-00270
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: