Burnett, Glenn Edward

Burnett, Glenn Edward is an individual health care provider with primary practice located at 555 E Broadway Ave Ste 201 , Jackson WY 83001-8640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Burnett, Glenn Edward can be contacted via phone (307) 733-7222.

Contact Information

Primary practice address
555 E Broadway Ave Ste 201 Jackson WY 83001-8640
Phone: (307) 733-7222
Fax: (307) 733-9720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 11577A Wyoming

Profile Details

NPI number 1467400747
LBN Legal business name Burnett, Glenn Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Jan 23rd, 2021 - about 4 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 1467400747 NPPES
Wyoming MEDICAID 150006600

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