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NPI Code Detail

MEDICARE: MR. JOHN W. BURNS MS, ATC, LAT

MEDICARE: MR. JOHN W. BURNS MS, ATC, LAT
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
12255A2300XAthletic Trainer24-00406KS

General Provider Information

NPI Number : 1255482576
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN W. BURNS MS, ATC, LAT
Provider Business Mailing Address
First Line : 1220 SW 32ND ST
Second Line :
City : TOPEKA
State : KS
Zip : 66611-2406
Country : US
Telephone Number : 785-670-2155
Fax Number :
Provider Business Practice Location Address
First Line : 1700 SW COLLEGE AVE
Second Line :
City : TOPEKA
State : KS
Zip : 66621-0001
Country : US
Telephone Number : 785-670-2155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 07/08/2007

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