Provider Demographics
NPI:1447790514
Name:BURN CRITICAL CARE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:BURN CRITICAL CARE ASSOCIATES, LLC
Other - Org Name:DR. MICHAEL QUINN PULMONARY CRITICAL CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-945-9110
Mailing Address - Street 1:3614 J. DEWEY GRAY CIRCLE
Mailing Address - Street 2:BLDG B.
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909
Mailing Address - Country:US
Mailing Address - Phone:706-504-4651
Mailing Address - Fax:706-504-4639
Practice Address - Street 1:3614 J. DEWEY GRAY CIRCLE
Practice Address - Street 2:BLDG B.
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909
Practice Address - Country:US
Practice Address - Phone:706-504-4651
Practice Address - Fax:706-504-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA61325207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty