Doctor Name: | CULLEN WILLIAM BURKE |
NPI Number: | 1063778645 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 5131 O'donovan Dr, Ste 300 Lsu-olol Psychiatric Services Center Baton Rouge, LA - 70808 |
Business Phone Number: | 2253740400 |
Business Fax Number: | 2253740430 |
Mailing Address: | 5131 O'donovan Dr, Ste 300, Lsu-olol Psychiatric Services Center BATON ROUGE |
State: | LA |
Postal Code: | 70808 |
Phone Number: | 2253740400 |
Fax Number: | 2253740430 |
NPI Enumeration Date: | 04/08/2012 |
NPI Last Update Date: | 11/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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. |