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General NPI Number Information
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NPI Number | 1215467758
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Entity Type | Individual
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Provider Name | ADAM BURNS OD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 3051 CAHILL MAIN
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City | FITCHBURG
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State | WI
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Zip | 53711
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Country | US
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Telephone | 608-251-4156
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Fax |
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Provider Business Mailing Address
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Address Line | 3051 CAHILL MAIN
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City | FITCHBURG
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State | WI
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Zip | 53711-7109
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Country | US
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Telephone | 608-251-4156
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3462
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3462-35
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License Number State | WI
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