Provider Demographics
NPI:1306866819
Name:BURKAM & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:BURKAM & ASSOCIATES, LLC
Other - Org Name:CONLEY REHABILITATION & SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RADLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:614-791-0700
Mailing Address - Street 1:3967 PRESIDENTIAL PKWY
Mailing Address - Street 2:STE C
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7271
Mailing Address - Country:US
Mailing Address - Phone:614-791-0700
Mailing Address - Fax:614-791-0702
Practice Address - Street 1:837 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1903
Practice Address - Country:US
Practice Address - Phone:614-326-1490
Practice Address - Fax:614-326-1495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBU9361191Medicare PIN