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General NPI Number Information
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NPI Number | 1649421629
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Entity Type | Organization
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Legal Business Name | JAMES K. BURKE, PH.D., P.S.C.
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 257 WATSON RD
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City | PAYNEVILLE
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State | KY
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Zip | 40157
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Country | US
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Telephone | 270-497-4840
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Fax | 270-497-4841
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Provider Business Mailing Address
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Address Line | 257 WATSON RD
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City | PAYNEVILLE
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State | KY
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Zip | 40157
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Country | US
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Telephone | 270-497-4840
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Fax | 270-497-4841
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | LAURA BURKE
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Credential |
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Telephone | 270-497-4840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0715
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License Number State | KY
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