Burnett, Charles Roland

Burnett, Charles Roland is an individual health care provider with primary practice located at 80 Humphreys Ctr Suite 202, Memphis TN 38120-2361. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Burnett, Charles Roland can be contacted via phone (901) 747-3330.

Contact Information

Primary practice address
80 Humphreys Ctr Suite 202 Memphis TN 38120-2361
Phone: (901) 747-3330
Fax: (901) 747-3245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD014125 Tennessee
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X C-5269 Arkansas

Profile Details

NPI number 1134122302
LBN Legal business name Burnett, Charles Roland
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Nov 19th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134122302 NPPES
Arkansas MEDICAID 107284001
Arkansas Other 000000039811
Arkansas MEDICAID 202043303
Arkansas Other 4118485
Arkansas Other P00372263
Arkansas Other 62116765701
Arkansas MEDICAID 3194515
Arkansas Other 4146198
Arkansas Other 81185
Arkansas MEDICAID 00013823
Arkansas Other 102G26
Arkansas Other P00378334

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