Healthcare Provider Details

I. General information

NPI: 1376734541
Provider Name (Legal Business Name): LAWRENCE E. BURNS DPM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 09/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 HARDING RD SUITE G12
NASHVILLE TN
37205-2018
US

IV. Provider business mailing address

104 WOODMONT BLVD SUITE LL-50
NASHVILLE TN
37205-2245
US

V. Phone/Fax

Practice location:
  • Phone: 615-301-7054
  • Fax: 615-301-7056
Mailing address:
  • Phone: 615-386-2300
  • Fax: 615-386-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberDPM 531
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberDPM 531
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberDPM 531
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM 531
License Number StateTN

VIII. Authorized Official

Name: LAWRENCE E. BURNS JR.
Title or Position: AUTHORIZED OFFICIAL
Credential: DPM
Phone: 615-301-7054