Provider Demographics
NPI:1801808654
Name:BURKHARDT, JOSEPH E (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:BURKHARDT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2 HERITAGE OAK LN
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4250
Mailing Address - Country:US
Mailing Address - Phone:269-979-6360
Mailing Address - Fax:269-979-6380
Practice Address - Street 1:2 HERITAGE OAK LN
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4250
Practice Address - Country:US
Practice Address - Phone:269-979-6360
Practice Address - Fax:269-979-6380
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012741207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200041730OtherRR MEDICARE
MI47623OtherCOMMUNITY CHOICE
MI4308470Medicaid
MI7607133OtherAETNA
MIJB012741OtherST LICENSE
MIP25349FOtherBCN
MI200000005551OtherPHP-JSOUTH MICHIGAN
MIP25349FOtherBCN