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General NPI Number Information
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NPI Number | 1477542942
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Entity Type | Individual
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Provider Name | KEVIN LYN BURNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1301 N RACE ST
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City | GLASGOW
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State | KY
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Zip | 42141-3454
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Country | US
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Telephone | 270-651-4175
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 ASHLEY CIR
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3362
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Country | US
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Telephone | 270-793-2416
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Fax | 270-793-2027
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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 | 37672
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License Number State | KY
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