Provider Demographics
NPI:1356306815
Name:BURKHARDT, JOHN D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:BURKHARDT
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 1:3000 N IH 35
Mailing Address - Street 2:SUITE 700
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1804
Mailing Address - Country:US
Mailing Address - Phone:512-807-3150
Mailing Address - Fax:512-458-7879
Practice Address - Street 1:3000 N IH 35
Practice Address - Street 2:SUITE 700
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1804
Practice Address - Country:US
Practice Address - Phone:512-807-3150
Practice Address - Fax:512-458-7879
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9893207RC0000X, 207RC0001X
OH35081144B207RC0000X
OH35-081144207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00136179OtherMEDICARE RAILROAD
OH2476600Medicaid
OH2476600Medicaid
TX8L2939Medicare PIN
TXTXB114866Medicare PIN
OHP00136179OtherMEDICARE RAILROAD
OHG64402Medicare UPIN
TX8L2864Medicare PIN