Healthcare Provider Details
I. General information
NPI: 1043231319
Provider Name (Legal Business Name): SHARON R BURNSIDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/22/2006
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6906 KINGSTON PIKE SUITE 200
KNOXVILLE TN
37919-5704
US
IV. Provider business mailing address
PO BOX 10687
KNOXVILLE TN
37939-0687
US
V. Phone/Fax
- Phone: 865-588-4044
- Fax:
- Phone: 865-588-4044
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD028113 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: