MEDICARE: MR. CRAIG W BURNS 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
1	207Q00000X	Family Medicine Physician	OS8074	FL

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

General Provider Information

NPI Number	:	1982605523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CRAIG W BURNS D.O.

Provider Business Mailing Address
First Line	:	4705 ALT 19
Second Line	:	SUITE. B
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1440
Country	:	US
Telephone Number	:	727-935-6477
Fax Number	:	727-935-6478

Provider Business Practice Location Address
First Line	:	4705 ALT 19
Second Line	:	SUITE. B
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1440
Country	:	US
Telephone Number	:	727-935-6477
Fax Number	:	727-935-6478

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

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	11/03/2016

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Directions to “ MR. CRAIG W BURNS D.O.” Practice Location

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