Burnham, Jeffrey Mark

Burnham, Jeffrey Mark is an individual health care provider with primary practice located at 10310 The Grove Blvd Ste 100 , Baton Rouge LA 70836-6455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Burnham, Jeffrey Mark can be contacted via phone (225) 761-5200.

Contact Information

Primary practice address
10310 The Grove Blvd Ste 100 Baton Rouge LA 70836-6455
Phone: (225) 761-5200
Fax: (225) 761-5702
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 017109 Louisiana

Profile Details

NPI number 1295729481
LBN Legal business name Burnham, Jeffrey Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Mar 30th, 2021 - about 5 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 1295729481 NPPES
Louisiana MEDICAID 1357502
Louisiana Other 080179868

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