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NPI Code Detail

MEDICARE: CALEEN BURKE

MEDICARE: CALEEN BURKE
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
1152W00000XOptometrist2918OK
2152W00000XOptometrist4051AR

General Provider Information

NPI Number : 1710406863
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALEEN BURKE
Provider Business Mailing Address
First Line : 18046 COUNTY ROAD 558
Second Line :
City : COLCORD
State : OK
Zip : 74338-3259
Country : US
Telephone Number : 417-252-1864
Fax Number :
Provider Business Practice Location Address
First Line : 3919 N MALL AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4906
Country : US
Telephone Number : 479-439-0131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2017
Last Update Date : 01/20/2026

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