Burris, David Allen

Burris, David Allen is an individual health care provider with primary practice located at 1875 Fant Dr , Fort Oglethorpe GA 30742-3307. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Burris, David Allen can be contacted via phone (706) 861-3387.

Contact Information

Primary practice address
1875 Fant Dr Fort Oglethorpe GA 30742-3307
Phone: (706) 861-3387
Fax: (706) 639-2054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1779 Georgia

Profile Details

NPI number 1437633088
LBN Legal business name Burris, David Allen
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2018
Last updated Sep 19th, 2018 - about 8 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 1437633088 NPPES
Georgia MEDICAID 00604513-GA

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