Doctor Name: | REED KARL BURK |
NPI Number: | 1023013760 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | P-155 |
Business Practice Address: | 1105 E Allen Rd Tahlequah, OK - 744642119 |
Business Phone Number: | 9189311471 |
Business Fax Number: | 9184589977 |
Mailing Address: | 1105 E Allen Rd, TAHLEQUAH |
State: | OK |
Postal Code: | 744642119 |
Phone Number: | 9189311471 |
Fax Number: | 9184589977 |
NPI Enumeration Date: | 06/18/2005 |
NPI Last Update Date: | 10/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | P-155 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ID |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |