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General NPI Number Information
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NPI Number | 1154399459
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Entity Type | Individual
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Provider Name | JAMES LEE BURKE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 5169 COTTONWOOD ST BLDG. B, SUITE 520
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City | MURRAY
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State | UT
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Zip | 84107-6767
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Country | US
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Telephone | 801-507-3500
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Fax | 801-507-3550
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Provider Business Mailing Address
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Address Line | 5169 COTTONWOOD ST BLDG. B, SUITE 520
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City | MURRAY
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State | UT
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Zip | 84107-6767
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Country | US
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Telephone | 801-507-3500
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Fax | 801-507-3550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 159207-1205
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License Number State | UT
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