Provider Demographics
NPI:1083278287
Name:KBURTONDPM LLC
Entity Type:Organization
Organization Name:KBURTONDPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-595-2932
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-6554
Mailing Address - Country:US
Mailing Address - Phone:614-864-9560
Mailing Address - Fax:614-864-9709
Practice Address - Street 1:662 SEAGULL CT
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8534
Practice Address - Country:US
Practice Address - Phone:614-595-2932
Practice Address - Fax:614-918-8371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty