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General NPI Number Information
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NPI Number | 1588851901
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Entity Type | Organization
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Legal Business Name | DENISE A. BURKE M.D. P.C.
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Dates
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Enumeration Date | 09/30/2007
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Last Update Date | 11/15/2009
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Provider Practice Location Address
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Address Line | 749 GOLF VIEW DR SUITE A
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City | MEDFORD
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State | OR
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Zip | 97504-9654
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Country | US
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Telephone | 541-779-4575
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Fax |
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Provider Business Mailing Address
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Address Line | 749 GOLF VIEW DR SUITE A
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City | MEDFORD
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State | OR
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Zip | 97504-9654
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Country | US
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Telephone | 541-779-4575
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENISE ANN BURKE
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Credential | M.D.
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Telephone | 541-779-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD17669
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License Number State | OR
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