Provider Demographics
NPI:1427037142
Name:BURNLEY, JONATHAN CARY (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CARY
Last Name:BURNLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E. DOCTOR HICKS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-366-1976
Mailing Address - Fax:205-967-0408
Practice Address - Street 1:501 E. DOCTOR HICKS BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-366-1976
Practice Address - Fax:205-967-0408
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051531206OtherBCBS
AL051531206Medicare PIN
ALV07299Medicare UPIN