MEDICARE: DR. LAURA ANDERSON BURNS M.D.

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	208000000X	Pediatrics Physician	30004	AL

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	511-16511	OTHER	AL	BLUE CROSS BLUE SHIELD OF AL
3	511-16512	OTHER	AL	BLUE CROSS BLUE SHIELD OF AL
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	511-16513	OTHER	AL	BLUE CROSS BLUE SHIELD OF ALABAMA

General Provider Information

NPI Number	:	1891956165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA ANDERSON BURNS M.D.

Provider Business Mailing Address
First Line	:	1700 AVENUE E
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35218-1543
Country	:	US
Telephone Number	:	205-788-3321
Fax Number	:	205-241-5260

Provider Business Practice Location Address
First Line	:	1700 AVENUE E
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35218-1543
Country	:	US
Telephone Number	:	205-788-3321
Fax Number	:	205-241-5260

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

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	11/22/2011

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Directions to “ DR. LAURA ANDERSON BURNS M.D.” Practice Location

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