Doctor Name: | DR. GERALD CRAIN BURNETT |
NPI Number: | 1205015229 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D/ |
License Number: | 0101017885 |
Business Practice Address: | 405 Oak Ln South Boston, VA - 245921633 |
Business Phone Number: | 4345726780 |
Business Fax Number: | 4345726033 |
Mailing Address: | 405 Oak Ln, Po Box 835 SOUTH BOSTON |
State: | VA |
Postal Code: | 245921633 |
Phone Number: | 4345726780 |
Fax Number: | 4345726033 |
NPI Enumeration Date: | 10/25/2007 |
NPI Last Update Date: | 04/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0101017885 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |