Provider Demographics
NPI:1083764195
Name:BURTON, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:BURTON
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 1:510 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4111
Mailing Address - Country:US
Mailing Address - Phone:413-443-4800
Mailing Address - Fax:413-442-9701
Practice Address - Street 1:510 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4111
Practice Address - Country:US
Practice Address - Phone:413-443-4800
Practice Address - Fax:413-442-9701
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48706174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000020943OtherHEALTHNET PLAN PIN
MA042714479OtherUNITED HEALTHCARE PIN
MA10925OtherHN PIN
MA441041175OtherPALMETTO GBA RR PIN
MA776514OtherTU PIN
MA2872348-001OtherCIGNA PIN
MA042714479OtherFIRST HEALTH PIN
MA04588OtherMVP PIN
MAI22280OtherBS PIN
MA0156485Medicaid
MA042714479OtherTRICARE PIN
MA042714479OtherGHI PIN
MA0482720OtherAETNA PIN
MAM20392Medicare ID - Type Unspecified
MA2872348-001OtherCIGNA PIN