Provider Demographics
NPI:1770697518
Name:BURTON, STEPHANIE W (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:W
Last Name:BURTON
Suffix:
Gender:F
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:A
Mailing Address - Street 2:3700 CAHABA BEACH ROAD
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242
Mailing Address - Country:US
Mailing Address - Phone:205-403-8902
Mailing Address - Fax:
Practice Address - Street 1:7559 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8811
Practice Address - Country:US
Practice Address - Phone:256-562-0850
Practice Address - Fax:256-562-0853
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32238207Q00000X
TN32238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3812471Medicaid
AL89009846OtherBCBS AL
TN4015749OtherBCBS TN
TN3812471Medicaid
TNG30864Medicare UPIN
TN1770697518Medicare NSC