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General NPI Number Information
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NPI Number | 1780617092
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Entity Type | Individual
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Provider Name | VICKI ELAINE BURDINE MD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 898 E MAIN ST
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City | GREENWOOD
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State | IN
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Zip | 46143-1407
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Country | US
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Telephone | 317-887-1348
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Fax | 317-888-1104
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Provider Business Mailing Address
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Address Line | 6362 W BOGGSTOWN RD
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City | BOGGSTOWN
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State | IN
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Zip | 46110-9731
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Country | US
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Telephone | 317-887-1348
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Fax | 317-888-1104
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01038302A
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License Number State | IN
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