MEDICARE: J J BURGIN MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1003604240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J J BURGIN MD LLC

Provider Business Mailing Address
First Line	:	1032 LOCHINVAR LN
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-8172
Country	:	US
Telephone Number	:	562-569-1601
Fax Number	:

Provider Business Practice Location Address
First Line	:	1032 LOCHINVAR LN
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-8172
Country	:	US
Telephone Number	:	562-569-1601
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JODE JANN BURGIN
Credential	:	MD
Telephone Number	:	562-569-1601

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	09/02/2025

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