Provider Demographics
NPI:1063444396
Name:BURK, JOY CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:CHRISTINE
Last Name:BURK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 4TH ST STE J
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-2363
Mailing Address - Country:US
Mailing Address - Phone:580-433-3333
Mailing Address - Fax:580-430-3305
Practice Address - Street 1:410 4TH ST STE J
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-2363
Practice Address - Country:US
Practice Address - Phone:580-430-3333
Practice Address - Fax:580-430-3305
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8796208000000X
OK18958208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1063444396Medicaid
OK10000292OtherOBNDD
OK10000292OtherOBNDD