Provider Demographics
NPI:1740216746
Name:BURKHARDT, BARRY WEBSTER (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:WEBSTER
Last Name:BURKHARDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:1400 JOHNSTON WILLIS DR
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4765
Practice Address - Country:US
Practice Address - Phone:804-379-8088
Practice Address - Fax:804-794-6067
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101023794207XS0114X
VA0101023794207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0900012OtherUNITED HEALTHCARE
VA386526OtherANTHEM WEST END OPERATORY
VA042950OtherANTHEM HEATHKEEPERS
VA0536731OtherAETNA HMO
VA2138260OtherUNITED HEALTHCARE MAMSI
VA285555OtherSOUTHERN HEALTH
VA1740216746Medicaid
VA18783OtherOPTIMA HEALTH
VA200012628OtherMEDICARE RAILROAD
VA30640OtherSH CARENET
VA540885859OtherCOMPMANAGEMENT
VA540885859OtherFIRST HEALTH/CCN
VA540885859OtherPRIVATE HEALTHCARE SYSTEM
VA006487840Medicaid
VA540885859OtherCIGNA
VA540885859OtherCORVEL
VA540885859OtherFOCUS
VA540885859OtherC&O EMPLOYEE'S HEALTHCARE
VA30640OtherSH CARENET
VA2138260OtherUNITED HEALTHCARE MAMSI
VA202949779Medicare PIN