NPI 1861474058 · live from the CMS NPI Registry
Kent Reynolds Burress, DPM
Podiatrist in Evansville, IN. National Provider Identifier 1861474058, active.
NPI record
| NPI | 1861474058 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 1819 Washington Ave, Evansville, IN 47714 |
| Practice phone | 812-457-7020 |
| Enumerated | November 15, 2005 |
| Last updated | February 7, 2008 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 0700515 (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.