Provider Demographics
NPI:1265474290
Name:BURNS, RUSSELL F (MD)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:F
Last Name:BURNS
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:PO BOX 7646
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-7646
Mailing Address - Country:US
Mailing Address - Phone:325-670-5566
Mailing Address - Fax:325-670-5568
Practice Address - Street 1:1401 AMBLER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2216
Practice Address - Country:US
Practice Address - Phone:325-670-5566
Practice Address - Fax:325-670-5568
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8815207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139328205Medicaid
TX139328205Medicaid
TXC13972Medicare UPIN