Provider Demographics
NPI:1154314607
Name:BURKHART, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BURKHART
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 1:2001 LAUREL AVE
Mailing Address - Street 2:STE 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:STE 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD003736207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2004820OtherBC OF TN
TN3566017Medicaid
2004820OtherBC OF TN
B02112Medicare UPIN
TN3566017Medicaid