Doctor Name: | DIANE MARIE BURNETT |
NPI Number: | 1750602215 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DIANE BURNETT, M.D. |
License Number: | 26310 |
Business Practice Address: | 1127 N Main St Cottonwood, AZ - 863263541 |
Business Phone Number: | 5207802298 |
Business Fax Number: | |
Mailing Address: | 1127 N Main St, COTTONWOOD |
State: | AZ |
Postal Code: | 863263541 |
Phone Number: | 5207802298 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2010 |
NPI Last Update Date: | 06/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 26310 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |