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NPI Code Detail

MEDICARE: KEVIN LYN BURNER M.D.

MEDICARE: KEVIN LYN BURNER M.D.
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
12085R0202XDiagnostic Radiology Physician37672KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
237672OTHERKYSTATE LICENSE #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477542942
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN LYN BURNER M.D.
Provider Business Mailing Address
First Line : 1801 ASHLEY CIR
Second Line :
City : BOWLING GREEN
State : KY
Zip : 42104-3362
Country : US
Telephone Number : 270-793-2416
Fax Number : 270-793-2027
Provider Business Practice Location Address
First Line : 1301 N RACE ST
Second Line :
City : GLASGOW
State : KY
Zip : 42141-3454
Country : US
Telephone Number : 270-651-4175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 03/07/2023

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Directions to “ KEVIN LYN BURNER M.D.” Practice Location

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