Provider Demographics
NPI:1922375609
Name:BURRIS, FRANK D (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:D
Last Name:BURRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:D
Other - Last Name:BURRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:13810 SHEPHERDS PATH E
Mailing Address - Street 2:APT.301
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-2455
Mailing Address - Country:US
Mailing Address - Phone:952-230-3599
Mailing Address - Fax:
Practice Address - Street 1:13810 SHEPHERDS PATH E
Practice Address - Street 2:APT.301
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55379-2455
Practice Address - Country:US
Practice Address - Phone:952-230-3599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101005020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine