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General NPI Number Information
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NPI Number | 1700865359
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Entity Type | Individual
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Provider Name | B FORREST BURKE MD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 1055 ROBERTA LANE # 103
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City | SPARKS
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State | NV
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Zip | 89431
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Country | US
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Telephone | 775-331-2600
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Fax | 775-331-2605
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Provider Business Mailing Address
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Address Line | 1055 ROBERTA LANE # 103
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City | SPARKS
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State | NV
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Zip | 89431
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Country | US
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Telephone | 775-331-2600
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Fax | 775-331-2605
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 8968
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 6253
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License Number State | NV
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