Provider Demographics
NPI:1053398339
Name:PURDOM, ERIC BURL (DO)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BURL
Last Name:PURDOM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 ANDERSON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-7603
Mailing Address - Country:US
Mailing Address - Phone:785-539-3504
Mailing Address - Fax:785-539-8597
Practice Address - Street 1:4201 ANDERSON AVE STE C
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-7603
Practice Address - Country:US
Practice Address - Phone:785-539-3504
Practice Address - Fax:785-539-8597
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-33198207Y00000X
HI02002559A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology