Provider Demographics
NPI:1114213253
Name:BURTON, ROBERT EVAN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EVAN
Last Name:BURTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 440454
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0454
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:7503 S NORTHSHORE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-8002
Practice Address - Country:US
Practice Address - Phone:865-531-1300
Practice Address - Fax:865-470-9190
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ014141Medicaid
TN103I117849Medicare PIN