Provider Demographics
NPI:1184761959
Name:STEVEN C BURKS MD & ASSOC INC
Entity type:Organization
Organization Name:STEVEN C BURKS MD & ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-206-4845
Mailing Address - Street 1:363 S BURNETT RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-2669
Mailing Address - Country:US
Mailing Address - Phone:937-206-4845
Mailing Address - Fax:937-325-6605
Practice Address - Street 1:363 S BURNETT RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-2669
Practice Address - Country:US
Practice Address - Phone:937-206-4845
Practice Address - Fax:937-325-6605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059708207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2038208Medicaid
OH9305531Medicare ID - Type Unspecified