Healthcare Provider Details

I. General information

NPI: 1821218140
Provider Name (Legal Business Name): TIMOTHY MARTIN BURKHART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 10/22/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OCCUPATIONAL HEALTH CLINIC, BLDG 3907 NAVAL HEALTH CLINIC
CHERRY POINT NC
28533-0023
US

IV. Provider business mailing address

OCCUPATIONAL HEALTH CLINIC, BLDG 3907 NAVAL HEALTH CLINIC PSC BOX 8023
CHERRY POINT NC
28533-0023
US

V. Phone/Fax

Practice location:
  • Phone: 524-664-4022
  • Fax:
Mailing address:
  • Phone: 252-466-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPENDING
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number2023-01069
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0101237081
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number2023-01069
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number0101237081
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: