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General NPI Number Information
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NPI Number | 1235372426
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Entity Type | Organization
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Legal Business Name | D. SCOTT BURKETT, M.D. (A MEDIAL CORPORATION)
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 513 WALNUT ST
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City | MONROE
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State | LA
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Zip | 71201-6229
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Country | US
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Telephone | 318-323-2328
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Fax | 318-323-2221
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Provider Business Mailing Address
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Address Line | 513 WALNUT ST
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City | MONROE
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State | LA
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Zip | 71201-6229
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Country | US
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Telephone | 318-323-2328
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Fax | 318-323-2221
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID SCOTT BURKETT
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Credential | M.D.
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Telephone | 318-323-2328
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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 | MD.15538R
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License Number State | LA
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