Provider Demographics
NPI:1376734541
Name:LAWRENCE E. BURNS DPM, INC
Entity Type:Organization
Organization Name:LAWRENCE E. BURNS DPM, INC
Other - Org Name:CENTER FOR FOOT AND WOUND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:615-301-7054
Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL-50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE G12
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2018
Practice Address - Country:US
Practice Address - Phone:615-301-7054
Practice Address - Fax:615-301-7056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM 531213EP1101X, 213ES0103X, 332BC3200X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1520027Medicaid
KY7100154100Medicaid
TN4239324OtherBLUE CROSS OF TN
TN0837250001Medicare NSC