Provider Demographics
NPI:1740762806
Name:BURTON, JOHN CURTIS (OD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CURTIS
Last Name:BURTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9909 ENSLEY LN
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66206-2460
Mailing Address - Country:US
Mailing Address - Phone:913-709-7656
Mailing Address - Fax:
Practice Address - Street 1:2100 E. MECHANIC STREET
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701
Practice Address - Country:US
Practice Address - Phone:816-884-5212
Practice Address - Fax:816-884-5212
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018024709152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist