Provider Demographics
NPI:1972589190
Name:BURNS, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 NEIL AVE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-7309
Mailing Address - Country:US
Mailing Address - Phone:614-221-7464
Mailing Address - Fax:614-221-8117
Practice Address - Street 1:262 NEIL AVE
Practice Address - Street 2:SUITE 430
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-7309
Practice Address - Country:US
Practice Address - Phone:614-221-7464
Practice Address - Fax:614-221-8117
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-02-7423B207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0108770Medicaid
OHA71031Medicare UPIN
OHBU0135553Medicare ID - Type Unspecified