MEDICARE: DR. CHRISTOPHER BURKS MD

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	207X00000X	Orthopaedic Surgery Physician	23635	MS
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	23635	MS

General Provider Information

NPI Number	:	1861620148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER BURKS MD

Provider Business Mailing Address
First Line	:	6300 E LAKE BLVD
Second Line	:	SUITE 301
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-6770
Country	:	US
Telephone Number	:	228-230-2663
Fax Number	:	228-206-1192

Provider Business Practice Location Address
First Line	:	6300 E LAKE BLVD
Second Line	:	SUITE 301
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-6770
Country	:	US
Telephone Number	:	228-230-2663
Fax Number	:	228-206-1192

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

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	03/22/2017

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