Provider Demographics
NPI:1811199474
Name:RICHARD J. BURNS, D.O., P.C.
Entity Type:Organization
Organization Name:RICHARD J. BURNS, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-961-3700
Mailing Address - Street 1:321 SPRUCE ST
Mailing Address - Street 2:SUITE 609
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1400
Mailing Address - Country:US
Mailing Address - Phone:570-961-3700
Mailing Address - Fax:570-343-6088
Practice Address - Street 1:321 SPRUCE ST
Practice Address - Street 2:SUITE 609
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1400
Practice Address - Country:US
Practice Address - Phone:570-961-3700
Practice Address - Fax:570-343-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-008562-L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017112680006Medicaid
PA0017112680006Medicaid
PAG82910Medicare UPIN