Provider Demographics
NPI:1851613129
Name:BURKLEY, DAVID PERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PERRY
Last Name:BURKLEY
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 1:221 WHISPERING WIND
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-4541
Mailing Address - Country:US
Mailing Address - Phone:801-450-5033
Mailing Address - Fax:
Practice Address - Street 1:221 WHISPERING WIND
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-4541
Practice Address - Country:US
Practice Address - Phone:801-450-5033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT150262-1205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist