MEDICARE: AUGUST BURNS PA

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	363A00000X	Physician Assistant	055-0030036	VT

General Provider Information

NPI Number	:	1437252996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUGUST BURNS PA

Provider Business Mailing Address
First Line	:	108 NO SWAMP ROAD
Second Line	:
City	:	NO MIDDLESEX
State	:	VT
Zip	:	05862
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 EAST MAIN STREET
Second Line	:
City	:	HYDE PARK
State	:	VT
Zip	:	05655
Country	:	US
Telephone Number	:	802-888-3077
Fax Number	:

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	04/26/2012

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Directions to “ AUGUST BURNS PA” Practice Location

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