| Doctor Name: | SUSAN MARY BURKHART |
| NPI Number: | 1447257571 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 104938 |
| Business Practice Address: | 801 Kidwell Drive St Mary's Clinic Versailles, MO - 65084 |
| Business Phone Number: | 5733785454 |
| Business Fax Number: | 5733785055 |
| Mailing Address: | P.o. Box 1027, JEFFERSON CITY |
| State: | MO |
| Postal Code: | 651021027 |
| Phone Number: | 5737617246 |
| Fax Number: | 5737616947 |
| NPI Enumeration Date: | 07/05/2005 |
| NPI Last Update Date: | 09/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 104938 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |