Provider Demographics
NPI:1568572725
Name:BURNS, STEVEN LESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LESTER
Last Name:BURNS
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 1:2570 NW EDENBOWER BLVD.
Mailing Address - Street 2:STE 100
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471
Mailing Address - Country:US
Mailing Address - Phone:541-957-1111
Mailing Address - Fax:541-229-3335
Practice Address - Street 1:2570 NW EDENBOWER BLVD.
Practice Address - Street 2:STE 100
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471
Practice Address - Country:US
Practice Address - Phone:541-957-1111
Practice Address - Fax:541-229-3335
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26561208D00000X
ORMD161469208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000A26561Medicaid
CA000A26561Medicaid