Provider Demographics
NPI:1245355544
Name:BURNS, LARRY ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:ALAN
Last Name:BURNS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2453 WILCOX DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-3956
Mailing Address - Country:US
Mailing Address - Phone:405-329-8120
Mailing Address - Fax:
Practice Address - Street 1:2453 WILCOX DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3956
Practice Address - Country:US
Practice Address - Phone:405-329-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1647207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine