MEDICARE: DR. ERIC BURL PURDOM D.O.

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	207Y00000X	Otolaryngology Physician	05-33198	KS

General Provider Information

NPI Number	:	1053398339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC BURL PURDOM D.O.

Provider Business Mailing Address
First Line	:	4201 ANDERSON AVE STE C
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66503-7603
Country	:	US
Telephone Number	:	785-539-3504
Fax Number	:	785-539-8597

Provider Business Practice Location Address
First Line	:	4201 ANDERSON AVE STE C
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66503-7603
Country	:	US
Telephone Number	:	785-539-3504
Fax Number	:	785-539-8597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	12/10/2025

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