John Michael Burnley, MD
Individual provider Active NPI Emergency Medicine Physician · Evansville, IN
NPI 1295839835 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1295839835
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 01027511A (IN)
- Practice address
- 600 Mary St
Evansville, IN 47747-0001 - Phone
- (812) 450-3405
- Fax
- (812) 450-3099
- NPI assigned
- Sep 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evansville Christian Life Center Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 01027511A | IN | Yes |
Addresses
Primary practice location
600 Mary St
Evansville, IN 47747-0001
Mailing address
PO Box 3407
Evansville, IN 47733-3407
Phone (812) 450-6815
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000381062 | Other | IN | BCBS - GATEWAY |
| 64876501 | Medicaid | KY | |
| 196308 | Other | IN | HEALTHLINK # |
| 064653 | Other | IN | HAMP # |
| 4005666 | Other | IN | AETNA # |
| 000000109159 | Other | IN | BCBS - MARY STREET |
| 719145 | Other | IN | FIRST HEALTH # |
Other providers in Evansville, IN
- Bryant Parker Burkett
- Emily R Burkett
- Sydney C Burkhart
- Susanna R Burkhead
- Hope Burkins
- Carolyn Sue Burns
- Mary Eugenia Burns
- Megan Elizabeth Burns
- Renae M Burns
- Sara Marie Burns
All providers in Evansville, IN · Emergency Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.