NPI 1639706963 · live from the CMS NPI Registry
Clyde Lucas Burnett, MD
Anesthesiology in Jackson, MS. National Provider Identifier 1639706963, active.
NPI record
| NPI | 1639706963 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology 207L00000X |
| Practice location | 2500 N State St, Jackson, MS 39216 |
| Practice phone | 601-984-5914 |
| Enumerated | March 25, 2020 |
| Last updated | July 6, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — (KY) |
| Anesthesiology primary | 207L00000X | T-4258 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.