MEDICARE: CONNOR ALAN BURTON

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	2255A2300X	Athletic Trainer
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1164813804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNOR ALAN BURTON

Provider Business Mailing Address
First Line	:	7730 VERONA DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-2785
Country	:	US
Telephone Number	:	260-417-9554
Fax Number	:

Provider Business Practice Location Address
First Line	:	7730 VERONA DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-2785
Country	:	US
Telephone Number	:	260-417-9554
Fax Number	:

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

Provider Enumeration Date	:	02/17/2015
Last Update Date	:	02/17/2015

Similar Medicare Providers

1063938041 — MR. JAMES ARNEL CRUZ ESPINOZA ATC
Practice Location Address:

1166 FORT ST STE 102
HONOLULU, HI
96813-2785

Practice Phone: 808-544-9360
Practice Fax: 808-543-8032

1508717547 — HA SAN
Practice Location Address:

1201 FARWOOD AVE
FORT WAYNE, IN
46816-1211

Practice Phone: 260-564-1374
Practice Fax:

1477547628 — DR. BRADLEY S BASHAM O.D.
Practice Location Address:

1515 E PAULDING RD
FORT WAYNE, IN
46816-1252

Practice Phone: 260-744-2273
Practice Fax: 260-744-4555

1639163884 — DR. PATRICE C ELLINGSON O.D.
Practice Location Address:

1515 E PAULDING RD
FORT WAYNE, IN
46816

Practice Phone: 260-744-2273
Practice Fax: 260-744-4555

1912968173 — MRS. PEGGY A. FARLOW MT-BC
Practice Location Address:

3333 REGIS DR
FORT WAYNE, IN
46816-1530

Practice Phone: 260-447-1703
Practice Fax: 260-447-1703

1356399182 — WAYNE YOUTH DENTISTRY, LLC
Practice Location Address:

7524 S ANTHONY BLVD
FORT WAYNE, IN
46816-2517

Practice Phone: 260-441-8500
Practice Fax: 260-441-0887

Directions to “ CONNOR ALAN BURTON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.