| Doctor Name: | DR. JOHN S BURRELL |
| NPI Number: | 1528062197 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD0000004016 |
| Business Practice Address: | 130 Independence Ln La Follette, TN - 377663031 |
| Business Phone Number: | 4235621705 |
| Business Fax Number: | 4235663718 |
| Mailing Address: | 831 Stephens Rd, LAKE CITY |
| State: | TN |
| Postal Code: | 377696126 |
| Phone Number: | 8654266719 |
| Fax Number: | 4235663718 |
| NPI Enumeration Date: | 06/10/2005 |
| NPI Last Update Date: | 06/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD0000004016 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |