Provider Demographics
NPI:1477546679
Name:BURKHART, HAROLD M (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:M
Last Name:BURKHART
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 CHILDRENS AVE
Mailing Address - Street 2:STE 2E
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4637
Mailing Address - Country:US
Mailing Address - Phone:405-271-5789
Mailing Address - Fax:405-271-1643
Practice Address - Street 1:1200 CHILDRENS AVE
Practice Address - Street 2:STE 2E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-5789
Practice Address - Fax:405-271-1643
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2016-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA35095208G00000X
MN102837208G00000X
OK30311208G00000X
MN41824208G00000X
WI53246208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200515750AMedicaid
IA0414433Medicaid
IA35127OtherWELLMARK BCBS
IAENROLLEDMedicaid
MN330004982OtherRAILROAD MEDICARE
WI34450000Medicaid
MN755719100Medicaid
WI34450000Medicaid
OK200515750AMedicaid
IA35127OtherWELLMARK BCBS
MN755719100Medicaid