Provider Demographics
NPI:1336103647
Name:BURKE, THOMAS VALENTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VALENTINE
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 N PICKAWAY ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1447
Practice Address - Country:US
Practice Address - Phone:740-420-8521
Practice Address - Fax:740-420-8526
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026060E207RC0200X, 207RP1001X
OH35.052417207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120012OtherHIGHMARK BLUE SHIELD
PAA72379OtherHEALTHAMERICA
PA11455OtherGEISINGER HEALTH PLAN
PA2467255OtherUNITEDHEALTHCARE
PA1008225230003Medicaid
PA5201496OtherAETNA
PA820730OtherFIRST PRIORITY HEALTH
PA1008225230001Medicaid
A72379Medicare UPIN
PA1008225230003Medicaid