MEDICARE: SAMUEL SCOTT BURCHFIELD MD

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	207Q00000X	Family Medicine Physician	E1234	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124098587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL SCOTT BURCHFIELD MD

Provider Business Mailing Address
First Line	:	630 W COURT ST
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-4247
Country	:	US
Telephone Number	:	870-236-6911
Fax Number	:	870-236-8129

Provider Business Practice Location Address
First Line	:	630 W COURT ST
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-4247
Country	:	US
Telephone Number	:	870-236-6911
Fax Number	:	870-236-8129

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	01/29/2014

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