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General NPI Number Information
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NPI Number | 1427152172
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Entity Type | Individual
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Provider Name | BRUCE E BURTON MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 1201 PLEASANT VALLEY RD
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City | OWENSBORO
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State | KY
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Zip | 42303-9811
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Country | US
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Telephone | 270-685-5165
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Fax | 270-683-0256
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Provider Business Mailing Address
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Address Line | 2101 E EL SEGUNDO BLVD STE 401
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4519
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Country | US
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Telephone | 270-685-5165
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Fax | 270-683-0256
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 24042
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License Number State | KY
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