Provider Demographics
NPI:1508085598
Name:BURNHAM, JAMES HARRELL (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HARRELL
Last Name:BURNHAM
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 1:1836 OSBORNE RD
Mailing Address - Street 2:
Mailing Address - City:ST MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558
Mailing Address - Country:US
Mailing Address - Phone:912-882-4377
Mailing Address - Fax:912-882-8434
Practice Address - Street 1:1836 OSBORNE RD
Practice Address - Street 2:
Practice Address - City:ST MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558
Practice Address - Country:US
Practice Address - Phone:912-882-4377
Practice Address - Fax:912-882-8434
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO01150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000565166AMedicaid
T97519Medicare UPIN