Healthcare Provider Details

I. General information

NPI: 1326289257
Provider Name (Legal Business Name): WILLIAM CHARLES BURGETTE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6810 PERIMETER DR STE 200
DUBLIN OH
43016-8013
US

IV. Provider business mailing address

340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US

V. Phone/Fax

Practice location:
  • Phone: 614-827-8700
  • Fax: 614-827-8701
Mailing address:
  • Phone: 614-545-7900
  • Fax: 614-545-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number34-01-0419
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number34.010419
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: