Provider Demographics
NPI:1710295696
Name:BURKE ROBINSON, MD, PC
Entity Type:Organization
Organization Name:BURKE ROBINSON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BURKE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:7701-667-3090
Mailing Address - Street 1:3400-C OLD MILTON PARKWAY
Mailing Address - Street 2:SUITE 515
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:770-667-3090
Mailing Address - Fax:678-867-0929
Practice Address - Street 1:3400-C OLD MILTON PARKWAY
Practice Address - Street 2:SUITE 515
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:770-667-3090
Practice Address - Fax:678-867-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039921174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD44410Medicare UPIN