Provider Demographics
NPI:1205491578
Name:BURTON, BRETT (DPM)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:BURTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W MONROE ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-2240
Mailing Address - Country:US
Mailing Address - Phone:762-282-2122
Mailing Address - Fax:276-228-7835
Practice Address - Street 1:680 W MONROE ST
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2240
Practice Address - Country:US
Practice Address - Phone:762-282-2122
Practice Address - Fax:276-228-7835
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301364213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery