Healthcare Provider Details

I. General information

NPI: 1518969468
Provider Name (Legal Business Name): WILLIAM E BURCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 05/11/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 NEW COVINGTON PIKE
MEMPHIS TN
38128-2504
US

IV. Provider business mailing address

1025 W OCEAN DR
KEY COLONY BEACH TN
33051-5123
US

V. Phone/Fax

Practice location:
  • Phone: 901-516-5211
  • Fax:
Mailing address:
  • Phone: 901-483-4745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME161926
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number31909
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number31909
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: