Provider Demographics
NPI:1902037872
Name:JAMES R. BURNS JR MD PC
Entity Type:Organization
Organization Name:JAMES R. BURNS JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:770-532-8441
Mailing Address - Street 1:675 WHITE SULPHUR RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-8921
Mailing Address - Country:US
Mailing Address - Phone:770-532-8441
Mailing Address - Fax:770-532-3756
Practice Address - Street 1:675 WHITE SULPHUR RD
Practice Address - Street 2:SUITE 170
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-8921
Practice Address - Country:US
Practice Address - Phone:770-532-8441
Practice Address - Fax:770-532-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009979261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA085001260GMedicaid
GA085001260GMedicaid