Doctor Name: | DR. FREDERICK N BURT |
NPI Number: | 1447263751 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | C3256 |
Business Practice Address: | 203 Mccomb St Wilmot, AR - 71676 |
Business Phone Number: | 8704732274 |
Business Fax Number: | 8704735392 |
Mailing Address: | Po Box 509, DERMOTT |
State: | AR |
Postal Code: | 71638 |
Phone Number: | 8705385414 |
Fax Number: | 8705385412 |
NPI Enumeration Date: | 08/15/2006 |
NPI Last Update Date: | 02/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C3256 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |