Provider Demographics
NPI:1356513998
Name:JAMES MACDONALD BURKHART MD
Entity type:Organization
Organization Name:JAMES MACDONALD BURKHART MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MACDONALD
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-523-0614
Mailing Address - Street 1:2001 LAUREL AVE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1810
Mailing Address - Country:US
Mailing Address - Phone:865-523-0614
Mailing Address - Fax:865-546-2625
Practice Address - Street 1:2001 LAUREL AVE
Practice Address - Street 2:SUITE 601
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1826
Practice Address - Country:US
Practice Address - Phone:865-523-0614
Practice Address - Fax:865-546-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0789340001Medicare NSC