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NPI Code Detail

MEDICARE: EMILY ELLEN BURNETTE D.O

MEDICARE: EMILY ELLEN BURNETTE D.O
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207V00000XObstetrics & Gynecology Physician34.012129OH

General Provider Information

NPI Number : 1588927834
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ELLEN BURNETTE D.O
Provider Business Mailing Address
First Line : 1319 E MAIN ST
Second Line :
City : LANCASTER
State : OH
Zip : 43130-4005
Country : US
Telephone Number : 740-687-2229
Fax Number : 740-785-9549
Provider Business Practice Location Address
First Line : 1319 E MAIN ST
Second Line :
City : LANCASTER
State : OH
Zip : 43130-4005
Country : US
Telephone Number : 740-687-2229
Fax Number : 740-785-9549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2012
Last Update Date : 03/27/2018

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Directions to “ EMILY ELLEN BURNETTE D.O” Practice Location

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