MEDICARE: DR. KELVIN B. BURTON 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
1	208VP0000X	Pain Medicine Physician	032101	GA
2	207Q00000X	Family Medicine Physician	032101	GA

General Provider Information

NPI Number	:	1487687331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELVIN B. BURTON M.D.

Provider Business Mailing Address
First Line	:	8464 ADAIR ST STE B
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-1836
Country	:	US
Telephone Number	:	770-942-1044
Fax Number	:	770-942-1699

Provider Business Practice Location Address
First Line	:	8464 ADAIR ST STE B
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-1836
Country	:	US
Telephone Number	:	770-942-1044
Fax Number	:	770-942-1699

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	06/12/2026

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