MEDICARE: LAWRENCE E. BURNS D.P.M.

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	213EP1101X	Primary Podiatric Medicine Podiatrist	531	TN
2	213E00000X	Podiatrist	531	TN
3	213ES0103X	Foot & Ankle Surgery Podiatrist	0531	TN
4	332BC3200X	Customized Equipment (DME)	531	TN
5	335E00000X	Prosthetic/Orthotic Supplier	531	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1104535	OTHER	TN	WINDSOR ADVANTAGE MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3146270	OTHER	TN	BLUE CROSS/BLUE SHIELD
3	2226259	OTHER		CIGNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4389487	OTHER		AETNA

General Provider Information

NPI Number	:	1588606347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE E. BURNS D.P.M.

Provider Business Mailing Address
First Line	:	104 WOODMONT BLVD
Second Line	:	SUITE LL-50
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2245
Country	:	US
Telephone Number	:	615-386-2361
Fax Number	:	615-386-2399

Provider Business Practice Location Address
First Line	:	2176 GOLF CLUB LN
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-1224
Country	:	US
Telephone Number	:	615-804-0581
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	08/19/2020

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