Provider Demographics
NPI:1205240736
Name:BURKETT, JULIE (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BURKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:POSEYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47633-0550
Mailing Address - Country:US
Mailing Address - Phone:812-874-2228
Mailing Address - Fax:812-874-2776
Practice Address - Street 1:40 W FLETCHALL ST
Practice Address - Street 2:
Practice Address - City:POSEYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47633-9015
Practice Address - Country:US
Practice Address - Phone:812-874-2228
Practice Address - Fax:812-874-2776
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11017771A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine