Doctor Name: | DAVID WATKINS BURKE |
NPI Number: | 1255454468 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | COT |
License Number: | 42218 |
Business Practice Address: | 3521 Graystone Pl Conover, NC - 286138201 |
Business Phone Number: | 8283222050 |
Business Fax Number: | 8283244271 |
Mailing Address: | Po Box 3122, MORGANTON |
State: | NC |
Postal Code: | 286803122 |
Phone Number: | 8284335760 |
Fax Number: | 8283244271 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1100X |
License Number: | 42218 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Ophthalmic |
Taxonomy Definition: |