Physician Compare National (NPI:1578531059)

HEALTHCARE PROVIDER: RICHARD J BURKETT M.D., P.A.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1578531059
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668568924
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071017000834
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BURKETT
	Individual professional last name
Provider First Name	RICHARD
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HAND SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HAND SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1770 E BROAD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	MANSFIELD
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760639145
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8174736969
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	670023
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	METHODIST MANSFIELD MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y