Provider Demographics
NPI:1154314953
Name:BURNS, WILLIAM BRANTLEY JR (M,D)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRANTLEY
Last Name:BURNS
Suffix:JR
Gender:M
Credentials:M,D
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1240 JESSE JEWELL PKWY SE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3862
Mailing Address - Country:US
Mailing Address - Phone:770-536-9864
Mailing Address - Fax:770-297-5011
Practice Address - Street 1:1240 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE 500
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3862
Practice Address - Country:US
Practice Address - Phone:770-536-9864
Practice Address - Fax:770-297-5011
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA10117207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE01104Medicare UPIN