Provider Demographics
NPI:1487634127
Name:BURKEY, JEFFREY A (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:BURKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:SEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44273-8864
Mailing Address - Country:US
Mailing Address - Phone:330-769-4695
Mailing Address - Fax:330-769-4936
Practice Address - Street 1:231 CENTER ST
Practice Address - Street 2:
Practice Address - City:SEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44273-8864
Practice Address - Country:US
Practice Address - Phone:330-769-4695
Practice Address - Fax:330-769-4936
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-075449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH1932400272OtherSEVILLE PRIMARY CARE TYPE 2 NPI #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH2214035Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH2214035Medicaid
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #