Provider Demographics
NPI:1942486436
Name:DR THOMAS T BURNS PLLC
Entity Type:Organization
Organization Name:DR THOMAS T BURNS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-731-1188
Mailing Address - Street 1:8187 RHODE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3279
Mailing Address - Country:US
Mailing Address - Phone:586-731-1188
Mailing Address - Fax:586-731-1184
Practice Address - Street 1:8187 RHODE DR
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317-3279
Practice Address - Country:US
Practice Address - Phone:586-731-1188
Practice Address - Fax:586-731-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F35015Medicare PIN
MIU16664MIMedicare UPIN