MEDICARE: DR. EDWIN NELSON BURFORD JR. DPH

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	183500000X	Pharmacist	9384	TN

General Provider Information

NPI Number	:	1215251517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWIN NELSON BURFORD JR. DPH

Provider Business Mailing Address
First Line	:	1710 SHELBY OAKS DR N STE 1
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-7403
Country	:	US
Telephone Number	:	901-201-5478
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 SHELBY OAKS DR N STE 1
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-7403
Country	:	US
Telephone Number	:	901-201-5478
Fax Number	:

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

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	12/19/2023

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