Provider Demographics
NPI:1649292079
Name:BURLING, JOHN N (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:BURLING
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 1:811 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072
Mailing Address - Country:US
Mailing Address - Phone:803-358-6100
Mailing Address - Fax:843-705-3828
Practice Address - Street 1:14 OKATIE CENTER BLVD. SOUTH
Practice Address - Street 2:SUITE 101
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909
Practice Address - Country:US
Practice Address - Phone:803-358-6100
Practice Address - Fax:843-705-3828
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA043175207P00000X, 207R00000X
SC30355207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00819768OtherRR MEDICARE (URGENTONE)
SC303558Medicaid
GA000735204COtherGA MEDICAID - SAVANNAH U/O
SC582162071-024OtherBCBSSC
SCP00456203OtherRR MEDICARE
GA000735204DOtherGA MEDICAID - POOLER U/O
GA000735204COtherGA MEDICAID - SAVANNAH U/O
GAC57734Medicare UPIN
SC582162071-024OtherBCBSSC