Provider Demographics
NPI:1417570557
Name:BURKE, RACHEL HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:HARRIS
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BELMONT DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4703
Mailing Address - Country:US
Mailing Address - Phone:229-224-4223
Mailing Address - Fax:
Practice Address - Street 1:729 PINE ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2106
Practice Address - Country:US
Practice Address - Phone:633-478-1634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-23
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program