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NPI 1588892590

NPI 1588892590 : JOSEPH C BURKETT MD : WEST COLUMBIA, SC

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General NPI Number Information
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    NPI Number           |    1588892590
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH C BURKETT MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/29/2009
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    Last Update Date     |    02/12/2014
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Provider Practice Location Address
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    Address Line         |    2720 SUNSET BLVD. 
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    City                 |    WEST COLUMBIA
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    State                |    SC
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    Zip                  |    29169
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    Country              |    US
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    Telephone            |    803-791-2000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2639 
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    City                 |    LEXINGTON
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    State                |    SC
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    Zip                  |    29071
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    Country              |    US
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    Telephone            |    803-791-2000
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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        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    2009015750
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    License Number State |    MO
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Taxonomy #2
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    35597
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    License Number State |    SC
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