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General NPI Number Information
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NPI Number | 1861531915
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Entity Type | Organization
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Legal Business Name | BURKE & ROBINSON MD PC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1501 E MILULI AVENUE
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City | BAINBRIDGE
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State | GA
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Zip | 39819
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Country | US
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Telephone | 229-243-0152
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Fax | 229-246-1683
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Provider Business Mailing Address
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Address Line | 1501 E MILULI AVENUE
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City | BAINBRIDGE
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State | GA
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Zip | 39819
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Country | US
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Telephone | 229-243-0152
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Fax | 229-246-1683
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PAULINE TYSON
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Credential |
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Telephone | 229-243-0152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 023914
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 22631
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License Number State | GA
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