Healthcare Provider Details

I. General information

NPI: 1003057241
Provider Name (Legal Business Name): BURKE ORTHOPAEDICS, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 04/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT JOSEPH DR
LEXINGTON KY
40504-3742
US

IV. Provider business mailing address

3741 WEMBLEY LN
LEXINGTON KY
40515-1274
US

V. Phone/Fax

Practice location:
  • Phone: 859-313-4855
  • Fax:
Mailing address:
  • Phone: 859-361-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number26486
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number26486
License Number StateKY

VIII. Authorized Official

Name: FRANK BURKE
Title or Position: OWNER
Credential: MD
Phone: 859-331-8885