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1457344277

NPI Code Detail

MEDICARE: GORDON D BURTCH MD

MEDICARE: GORDON D BURTCH 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	208600000X	Surgery Physician	ME0040302	FL
2	2086S0129X	Vascular Surgery Physician	ME0040302	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	020032360	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2012355	OTHER		AETNA HMO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4110614	OTHER		AETNA PPO
5	15808	OTHER	FL	BLUE CROSS BLUE SHIELD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457344277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORDON D BURTCH MD

Provider Business Mailing Address
First Line	:	6821 PALISADES PARK CT
Second Line	:	SUITE 1
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7131
Country	:	US
Telephone Number	:	239-936-8555
Fax Number	:	239-936-5611

Provider Business Practice Location Address
First Line	:	6821 PALISADES PARK CT
Second Line	:	SUITE 1
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7131
Country	:	US
Telephone Number	:	239-936-8555
Fax Number	:	239-936-5611

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	08/29/2014

Similar Medicare Providers

1063411841 — DR. JOHN ANTHONY MOSS D.O.
Practice Location Address:

6821 PALISADES PARK CT STE 1
FORT MYERS, FL
33912-7131

Practice Phone: 239-936-8555
Practice Fax: 239-936-5611

1447243134 — ANTHONY J D'ANGELO MD
Practice Location Address:

6821 PALISADES PARK CT , SUITE 1
FORT MYERS, FL
33912-7131

Practice Phone: 239-936-8555
Practice Fax: 239-936-5611

1932193364 — JOSE F MANIBO MD
Practice Location Address:

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FORT MYERS, FL
33912-7131

Practice Phone: 239-936-8555
Practice Fax: 239-936-5611

1033103437 — SURGICAL SPECIALISTS OF SOUTHWEST FLORIDA P.A.
Practice Location Address:

6821 PALISADES PARK CT , SUITE 1
FORT MYERS, FL
33912-7131

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Practice Fax: 239-936-5611

1942294343 — AJAY KALRA MD
Practice Location Address:

6821 PALISADES PARK CT
FORT MYERS, FL
33912-7131

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Practice Fax: 239-936-5611

1326003997 — THAD KAMMERLOCHER MD
Practice Location Address:

6821 PALISADES PARK CT , SUITE 1
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33912-7131

Practice Phone: 239-936-8555
Practice Fax: 239-936-5611

Directions to “ GORDON D BURTCH MD” 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.

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