MEDICARE: DR. JAMES TRAVIS BURT M.D., F.A.C.S.

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	207T00000X	Neurological Surgery Physician	0101056734	VA
2	207T00000X	Neurological Surgery Physician	0000026843	TN

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619983962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES TRAVIS BURT M.D., F.A.C.S.

Provider Business Mailing Address
First Line	:	1 MEDICAL PARK BLVD STE 400E
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7431
Country	:	US
Telephone Number	:	423-844-5400
Fax Number	:	423-844-5434

Provider Business Practice Location Address
First Line	:	1 MEDICAL PARK BLVD STE 400E
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7431
Country	:	US
Telephone Number	:	423-844-5400
Fax Number	:	423-844-5434

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	03/21/2025

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