| Doctor Name: | BASIL OMAR BURNEY |
| NPI Number: | 1043414485 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D |
| License Number: | 2005019858 |
| Business Practice Address: | 1801 Pine St Suite 203 Montgomery, AL - 361060165 |
| Business Phone Number: | 3342938877 |
| Business Fax Number: | 3342936803 |
| Mailing Address: | 2257 Taylor Rd, Suite 200 MONTGOMERY |
| State: | AL |
| Postal Code: | 361177790 |
| Phone Number: | 3342709914 |
| Fax Number: | 3342703195 |
| NPI Enumeration Date: | 06/11/2007 |
| NPI Last Update Date: | 08/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 2005019858 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |