Provider Demographics
NPI:1144273772
Name:BURNS, BRYAN W (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:W
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 W 160TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8100
Mailing Address - Country:US
Mailing Address - Phone:913-814-8800
Mailing Address - Fax:913-948-9320
Practice Address - Street 1:7500 W 160TH ST STE 200
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:KS
Practice Address - Zip Code:66085-8100
Practice Address - Country:US
Practice Address - Phone:913-814-8800
Practice Address - Fax:913-948-9320
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100320280AMedicaid
KS100320280AMedicaid
G64891Medicare UPIN