Healthcare Provider Details

I. General information

NPI: 1114213253
Provider Name (Legal Business Name): ROBERT EVAN BURTON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7503 S NORTHSHORE DR
KNOXVILLE TN
37919-8002
US

IV. Provider business mailing address

PO BOX 440454
NASHVILLE TN
37244-0454
US

V. Phone/Fax

Practice location:
  • Phone: 865-531-1300
  • Fax: 865-470-9190
Mailing address:
  • Phone: 865-670-6199
  • Fax: 865-670-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2844
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: