Healthcare Provider Details
I. General information
NPI: 1538498159
Provider Name (Legal Business Name): LAWRENCE E. BURNS, DPM, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2009
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4230 HARDING RD SUITE G-12
NASHVILLE TN
37205-2013
US
IV. Provider business mailing address
104 WOODMONT BLVD SUITE LL50
NASHVILLE TN
37205-2245
US
V. Phone/Fax
- Phone: 615-301-7054
- Fax:
- Phone: 615-386-2300
- Fax: 615-386-2399
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | 0531 DPM |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | 0531 DPM |
| License Number State | TN |
VIII. Authorized Official
Name: DR.
LAWRENCE
E
BURNS
Title or Position: SOLE PROPRIETOR
Credential: DPM
Phone: 615-386-2300