Provider Demographics
NPI:1205893039
Name:BURRELL FAMILY & OBSTETRICAL CARE PA
Entity type:Organization
Organization Name:BURRELL FAMILY & OBSTETRICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-349-6660
Mailing Address - Street 1:121 RIVERVIEW STREET
Mailing Address - Street 2:STE B
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734
Mailing Address - Country:US
Mailing Address - Phone:828-349-6660
Mailing Address - Fax:828-349-6664
Practice Address - Street 1:121 RIVERVIEW STREET
Practice Address - Street 2:STE B
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-349-6660
Practice Address - Fax:828-349-6664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
016AYOtherBCBS - GROUP #
NC89016AYMedicaid
NC89016AYMedicaid