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General NPI Number Information
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NPI Number | 1770526170
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Entity Type | Individual
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Provider Name | JOAN BURKS PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 1100 JOHNSON FERRY RD NE STE 425 CENTER POINTE I
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City | ATLANTA
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State | GA
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Zip | 30342-1745
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Country | US
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Telephone | 404-252-2666
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Fax | 404-252-0890
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Provider Business Mailing Address
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Address Line | 5473 COBURN CT
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City | ATLANTA
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State | GA
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Zip | 30338-3035
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Country | US
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Telephone | 404-597-7359
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Fax | 770-394-6748
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4106
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License Number State | GA
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