MEDICARE: MARIA 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	207Q00000X	Family Medicine Physician	33129	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1538146014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA BURTON M.D.

Provider Business Mailing Address
First Line	:	1955 DIXIE HWY STE N
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2792
Country	:	US
Telephone Number	:	859-341-6255
Fax Number	:	859-547-1197

Provider Business Practice Location Address
First Line	:	1955 DIXIE HWY STE N
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2792
Country	:	US
Telephone Number	:	859-341-6255
Fax Number	:	859-547-1197

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

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	05/06/2022

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